ABSTRACT
Objetivo: Estudiar el gasto por paciente en atención primaria y el peso de los distintos recursos según edad y sexo. Diseño: Estudio descriptivo retrospectivo. Análisis de costes. Emplazamiento: 14 centros de atención primaria (población asignada: 313.000). Participantes: Personas visitadas en 2008 (227.235). Período de estudio: enero a diciembre de 2008. Mediciones principales: De la historia informatizada: edad, sexo, visitas, solicitudes de laboratorio, radiografías, pruebas complementarias y derivaciones; y de la facturación a farmacias el gasto farmacéutico. Los costes fijos/semifijos se repartieron entre las visitas obteniendo un coste medio. Se asignaron costes de laboratorio (gasto medio por petición), radiología y pruebas complementarias (gasto según prueba) y derivaciones (tarifa adaptada). Estadística descriptiva de los datos (medianas, rangos intercuartílicos y coeficientes de variación). Resultados: Mediana del gasto: 362 € (321 € en hombres y 396 € en mujeres). En menores de 2 años fue 410 €, de 15 a 44 años 203 € y en mayores de 75 años de 1.255 €. Hasta los 2 años las visitas representaron el 81% del gasto y farmacia el 8%. En mayores de 75 años las visitas el 21% y farmacia el 63%. Conclusiones: El gasto en atención primaria es superior en mujeres aunque las mayores diferencias se aprecian con la edad. En mayores de 74 años la mediana sextuplica a la de 15-44 años. En pediatría el mayor peso lo tienen las visitas, hasta los 2 años representa el 80% del total. A partir de los 45 es principalmente por farmacia que supera el 60% en mayores de 74 años(AU)
Objective: To study the primary care expenditure per person and the weight of different health resources within sex and age groups. Design: Cost analysis. Retrospective descriptive study. Setting: 14 urban primary care centers (assigned population: 313,000). Participants: All patients who visited during 2008 (227,235). Study period: January to December 2008. Main measurements: Age, sex, visits, laboratory, radiology and complementary tests and referrals to specialists were obtained from patient electronic files. Pharmacy expenditure was obtained from invoices sent to the national health system by pharmacists. Fixed/semi-fixed costs were distributed among visits and a mean cost/visit was obtained. Costs were assigned for laboratory (mean application cost), for radiology and complementary tests (rate per type of test) and for referrals (adjusted rate). Descriptive analysis of data (median, interquartile range and coefficient of variance). Results: Median expenditure was 362 € (321 € for men and 396 € for women). For the up to 2 year-old group it was 410 €, for aged 15-44 203 € and 75 and above 1,255 €.). The up to 2 years old visits represented 81% of total cost while pharmacy was 8%, while for those aged 75 and above visits accounted for 21% of the total cost and pharmacy 63%. Conclusions: Expenditure in primary care is higher in women, although the greatest differences were observed with age. In older than 74 years the median expenditure was six-fold higher than that for 3-44 years old group. In pediatrics the main source of expenditure was visits, representing 80% of the total in up to 2 years old. From 45 years old, pharmacy was the main source of expenditure and in those older than 74 it represented over 60% of the total(AU)
Subject(s)
Humans , Health Expenditures/statistics & numerical data , Primary Health Care/economics , Health Care Rationing/statistics & numerical data , Age and Sex Distribution , 16672/trendsABSTRACT
OBJECTIVE: To study the primary care expenditure per person and the weight of different health resources within sex and age groups. DESIGN: Cost analysis. Retrospective descriptive study. SETTING: 14 urban primary care centers (assigned population: 313,000). PARTICIPANTS: All patients who visited during 2008 (227,235). STUDY PERIOD: January to December 2008. MAIN MEASUREMENTS: Age, sex, visits, laboratory, radiology and complementary tests and referrals to specialists were obtained from patient electronic files. Pharmacy expenditure was obtained from invoices sent to the national health system by pharmacists. Fixed/semi-fixed costs were distributed among visits and a mean cost/visit was obtained. Costs were assigned for laboratory (mean application cost), for radiology and complementary tests (rate per type of test) and for referrals (adjusted rate). Descriptive analysis of data (median, interquartile range and coefficient of variance). RESULTS: Median expenditure was 362 (321 for men and 396 for women). For the up to 2 year-old group it was 410 , for aged 15-44 203 and 75 and above 1,255 .). The up to 2 years old visits represented 81% of total cost while pharmacy was 8%, while for those aged 75 and above visits accounted for 21% of the total cost and pharmacy 63%. CONCLUSIONS: Expenditure in primary care is higher in women, although the greatest differences were observed with age. In older than 74 years the median expenditure was six-fold higher than that for 3-44 years old group. In pediatrics the main source of expenditure was visits, representing 80% of the total in up to 2 years old. From 45 years old, pharmacy was the main source of expenditure and in those older than 74 it represented over 60% of the total.
