ABSTRACT
OBJECTIVES: To find the profile of the Family Planning (FP) service, the contraceptive methods used, prescribed and asked for, evaluating the knowledge acquired in the prior informative talk. DESIGN: A crossover observational study. SETTING: Family Planning service in Telde (Gran Canaria). PATIENTS AND PARTICIPANTS: 317 users for whom a clinical record was opened in 1992/3. MEASUREMENTS AND MAIN RESULTS: Average age was 28.23 +/- 0.75 (SD 6.76); 77.6% were married, 66.56% without paid work and 22.71% with medium or higher education. 62.77% were from our Health Area. 82.33% attended on their own initiative. 2.26 +/- 0.07 (SD 0.59) contraceptive methods per user were used, with 71.87% medically monitored. 98.74% had used hormonal contraception (HC). The average number of pregnancies was 1.45 +/- 0.13 (SD 1.2), with the first being on average at age 22.16 +/- 0.48 (SD 3.74). 32.67% used barrier methods and 35.31% hormonal ones (36.4% smoked), with significant differences for age-groups, the referring professional and the number of children. 60% asked for an IUD and 37.38% HC, where significant differences were found for marital status, age groups, educational level and the number of children. CONCLUSIONS: We must strengthen the FP service so that people can make the most of their sexual and reproductive lives, increasing coverage for adolescents to prevent unwanted pregnancies and avoid uncontrolled risky contraceptive methods. The information in the prior talks should be improved, which would make the questionnaires administered more valid.
Subject(s)
Family Planning Services/statistics & numerical data , Adolescent , Adult , Demography , Female , Humans , Middle AgedABSTRACT
OBJECTIVE: To analyse the prescription of antibiotics for acute respiratory infections (ARI) at our Health Centre. DESIGN: An observational crossover study. SETTING: Primary Health care. San Gregorio de Telde Health Centre, Gran Canaria. PATIENTS AND PARTICIPANTS: Systematic random sampling of 368 clinical cases with ARI. 196 women (53.26%) and 172 men (46.73%), with an average age of 33.26 +/- 1.97. MEASUREMENTS AND MAIN RESULTS: Antibiotics were prescribed for 42.66% of ARI. Family doctors used them less than general ones (38.67% against 63.04%, p < 0.0001), and on the afternoon lists they were used less than in the morning (33.82% against 52.35%, p < 0.001). In chronically ill patients they were used less than symptomatic treatment (42.16% against 57.83%, p < 0.001). There were no significant differences found between their use and the appearance of complications (37.5% with Antibiotherapy against 62.5% without it) or successive consultations (45.16% with antibiotics against 54.83% without them). They were used more in those aged over 60 (48.97%) and in those who attended less (51.56%). Average cost per patient treated with Antibiotherapy was 2,508.48 +/- 258.80 pesetas against 694.28 +/- 78.67 pesetas for the patient treated symptomatically (p < 0.0005). CONCLUSIONS: We are using Antibiotherapy inadequately in our field. We propose that quality control studies to detect and correct problems of this type should be undertaken. In our case corrective measures with a later reevaluation should be applied.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Prescriptions , Respiratory Tract Infections/drug therapy , Acute Disease , Adult , Cross-Over Studies , Family Practice , Female , Humans , Male , Middle Aged , Primary Health Care , Random AllocationABSTRACT
OBJECTIVE: To discover the level of agreement about the radiological interpretation of the growth of left-side cardiac cavities, between the referring radiologist (Rx), a family doctor (FD) and three interns studying the third year of family and community medicine (IFCM). DESIGN: Observational crossover study. SETTING: Primary Care (PC). The Perpetuo Socorro Health Centre in Huesca. PATIENTS AND OTHER PARTICIPANTS: Hypertense patients included in the programme of one of the general medicine sections. MEASUREMENTS AND MAIN RESULTS: There were 69 thorax radiographies (TXR), 10 of which were repeated in order to assess the level of agreement between different evaluations by the same observer (intra-observer). Out of these 69, there was agreement between observers in 39 cases (66.10%) with Kappa Index (KI) 0.39 +/- 0.12 for two IFCMs (2 and 3); in 44 (74.57%), with KI 0.55 +/- 0.12 for the first IFCM; and in 40 (67.10%), with KI 0.39 +/- 0.12 for the FD. The intra-observer agreement was 80% with KI 0.50 +/- 0.29, 60% with KI 0.20 +/- 0.23 and 90% with KI 0.80 +/- 0.23 for the three IFCM's. It was 70% with KI 0.34 +/- 0.27 for the FD and 80% with KI 0.48 +/- 0.29 for the Rx. CONCLUSIONS: Both the inter- and intra-observer agreement levels were insufficient. We propose that our training during the period of specialisation should be strengthened on the most useful questions from the PC point of view. Studies of this sort need to be carried out in PC in order to obtain maximum benefit from these complementary tests.
