[Effects of chronic diseases on the use of primary care by the aged]. / Influencia de la patología crónica sobre la utilización de atención primaria en la tercera edad.

OBJECTIVE: To analyse how often elderly people attend Primary Care (PC) consulting rooms and how attendance is affected by the number and kind of chronic pathologies those elderly people suffer. SETTING: A medical list from each of three Health Centres in the city of Granada was chosen. PATIENTS: All those over 65 registered on these lists from 1990 to 1994 inclusive, 711 people in total, were included. The number of attendances and chronic illnesses were obtained from the Clinical Records. The outcome variable "Mean Annual Consultations" (MAC) over the study period was analysed by ANOVA and multiple linear regression. RESULTS: MAC was 5.79 (SD 4.20), with a range from 0 to 27 consultations. MACs were significantly higher among the elderly registered at the Doctors' Health Centre (p < 0.001), among women (p < 0.05) and for the presence of any of the pathologies under consideration (p < 0.01) except dementia. A relationship was found between the number of comorbidities and MAC (p < 0.001). In the scaled multiple regression analysis, the number of comorbidities, the first variable introduced into the model, explained 33% of variability in use. CONCLUSIONS: The number of chronic pathologies strongly determines elderly people's attendance at PC consulting rooms, independently of the kind of illness they suffer from.

[Assessment of health needs of the aged]. / Valoración de necesidad en el anciano.

The increase of ancient population constitutes a challenge for society in general and for the health services in particular in relation with the offer planning and adequacy. It is important to know the health needs and status of our old people population to determine the intervention priorities and, on the other part, to measure the programmes efficiency and efficacy. As years go on, body organs get old in a different way, which leads to individual variations in the speed of organs and systems deterioration; that is why, a reasonable good scale of and overall health does not exist in contrast with functional status and psychological health. Certain cultural attitudes towards aging and the health care resources availability make measurement more difficult, as well. For all elaborated with and overall point of view, by means of a systematic search of problems and a total valuation of his health needs.

[Inter-episode continuity of primary health care: proposal for an indicator]. / La continuidad interepisodios en atención primaria de salud: propuesta de un indicador.

The objective of this study was to assess the quality of the data included in patients' personal histories and to prepare an indicator of the continuity of health care between episodes of illness based on the information contained in these records. The study was descriptive. Public health specialists from the Department of Preventive Medicine of the University of Granada, Spain, participated in the design and analysis, and the field work was carried out by specialists from family and community medicine from the Zaidín-Sur Health Center of Granada, where the research was conducted in April to December 1989. For the study, 1581 personal histories were analyzed. The most complete records were those having to do with personal background (37% of the personal histories evaluated) and the most complete histories were those of pediatric patients, women, and persons who participated in programs organized by the health center. The degree of completeness of the records was low. Based on the indicator developed, only 16% of the histories at the Center contained sufficient information to allow continuity of care. It is recommended that simple records systems be created and that primary care physicians be educated in the collection of essential data.

[A survey on the satisfaction of the users of the Zaidin-Sur de Granada Health Center (1989)]. / Encuesta de satisfacción a usuarios del Centro de Salud Zaidin-Sur de Granada (1989).

In order to know the users's degree of satisfaction in the Primary Health Care Center of Zaidin-Sur in Granada, a survey has been carried out by means of a personal interview at home in an aleatory sample of 615 individuals. The questionnaire has 28 closed questions with multiple answer and collects sociodemographic variables, self-perception of health condition, acceptability of medical and nursery care. The interview was anonymous and carried out by nursery students of third year. The 52% of the sample expressed that his health level was "excellent" or "good" and it was worse when the educational level was lower and the age was higher. The group of workers showed the highest valuation of health condition. The levels of trust on the doctor, the time of dedication and the information given to the patient reach slightly lower values than the ones found in literature; personal treatment and interest towards the patient have been valued the best. Center space structure and timetable have been the most penalized variables. We conclude that there is a need of improving the nursery service care a need of the information, from all the professionals working in the center, given to the patients on their problems, which are the cause of their going to the health consult, and the need of enlarging the space of the center.

[Quality of medical records at a primary care center]. / Estudio de la calidad de los registros en un centro de atención primaria.

The quality of the clinical records included in the clinical charts is assessed through a sample of the clinical charts existing at the Health Center Zaidin-Sur (Granada, Spain). The quality was ascertained via the number of visits annotated, the number of records considered as essential (life style, family and personal history), and the number of received or requested consultation. This information is compared to the data of the general files of the Health Center, to the information gathered by a direct interview (performed to assess the validity of the essential records), and to the results of a protocol studying the visit activities. The analysis of data shows that just a 40.4% of the visits are annotated on the clinical chart. A lower percentage of the essential records were annotated, 37.6%. The requested consultations are annotated in 43.8% and the received ones in 87.6%. We discuss on the need of periodic evaluation of the records to show their limitations and deficiencies. This is the first step to improve them.

[Anti-flu vaccination: satisfaction study in a vaccinated population]. / Vacunación antigripal: estudio de satisfacción en una población vacunada.

Most of the studies on the coverage of our country with regard to flu vaccinations reveal figures which do not surpass 50%-70% of the target population. In the USA, this figure only amounts to 20%-30%. There seems to be a certain "reticence" on the part of the population with regard to taking these injections or to continue the vaccination programs yearly. For this reason, we have made a prospective surveillance and monitoring study of the individuals vaccinated with the flu vaccine, which has taken in two flu injection campaigns (1988-1989) for the purpose of ascertaining the possible causes of this "reticence" and the degree of satisfaction achieved with the flu vaccine procedures. The study reveals the only 51.8% of the population receiving the vaccine was satisfied with the procedure, although 75.2% repeated the procedure the following year. The highest degree of insatisfaction is shown among women, and the customary patients who visit their physicians for every ache and pain, and those receiving the vaccine for the first time confuse acute respiratory symptoms with flu symptoms.