¿Recomendar la frecuencia de administración de medicamentos en la prescripción electrónica mejora su adecuación? Estudio antes-después / Does recommending the dosing frequency in the electronic prescription improve its adequacy? Before and after study

Objetivo: Analizar si informar la frecuencia de administración (FA) en el módulo de prescripción de la estación clínica de atención primaria (ECAP) del Institut Català de la Salut (ICS) mejora la adecuación de la FA de las prescripciones. Diseño: Estudio de adecuación antes-después con control no equivalente de prescripciones sin cambios en la FA. El periodo de estudio incluye desde el 1 de septiembre de 2019 hasta el 29 de febrero de 2020.Emplazamiento: Ámbito de atención primaria. Participantes: Se incluyen las prescripciones de los medicamentos con una única FA adecuada o mayoritariamente adecuada realizadas por los médicos de familia del ICS durante el periodo de estudio.IntervenciónRecomendar la FA adecuada en el módulo de prescripción. Mediciones principales: Adecuación definida como la coincidencia entre la FA prescrita y la FA adecuada. Resultados: Tras la intervención se produjo un aumento del 22,75% de prescripciones con FA adecuada. El mayor aumento se dio en los medicamentos del sistema genitourinario y hormonas sexuales. En términos absolutos, el grupo de antiinfecciosos es el que obtuvo más prescripciones con FA adecuada entre los dos periodos. Conclusiones: La intervención aumentó la adecuación en la FA de las prescripciones, lo que supone una mejora en la seguridad y en la eficacia de los tratamientos. Se evidencia que el diseño y la implantación de mejoras en los sistemas de prescripción electrónica contribuye a aumentar la calidad de la prescripción.(AU)

Objective: To assess whether reporting the dosing frequency into the prescription module of the Institut Català de la Salut (ICS) primary care electronic clinical workstation improves the dosing frequency's adequacy of the prescriptions. Design: Before and after study with non-equivalent control of prescriptions without any change in the dosing frequency. The study periods includes from September 1st, 2019 to February 29th, 2020.Location: Primary care setting. Participants: Prescriptions issued by ICS General Practitioner, during the study period of those medicines which indications have a single appropriate dosing frequency or mostly appropriate, are included.Intervention: Recommendation of the appropriate dosing frequency in the prescription module. Main measurements: Adequacy defined as the coincidence between the prescribed dosing frequency and the appropriate dosing frequency. Results: After the intervention there was a 22.75% increase in prescriptions with adequate dosing frequency. The largest increase occurred in the medicines for the genitourinary system and sex hormones. In absolute terms, the group of anti infective for systemic use is the one that obtained more prescriptions with an adequate dosing frequency between the two periods. Conclusions: The intervention increased the dosing frequency's adequacy leading to improvements in the safety and effectiveness of the treatments. It is evident that the design and implementation of improvements in electronic prescription systems contributes to increasing the quality of the prescription.(AU)

[Does recommending the dosing frequency in the electronic prescription improve its adequacy? Before and after study]. / ¿Recomendar la frecuencia de administración de medicamentos en la prescripción electrónica mejora su adecuación? Estudio antes-después.

OBJECTIVE: To assess whether reporting the dosing frequency into the prescription module of the Institut Català de la Salut (ICS) primary care electronic clinical workstation improves the dosing frequency's adequacy of the prescriptions. DESIGN: Before and after study with non-equivalent control of prescriptions without any change in the dosing frequency. The study periods includes from September 1st, 2019 to February 29th, 2020. LOCATION: Primary care setting. PARTICIPANTS: Prescriptions issued by ICS General Practitioner, during the study period of those medicines which indications have a single appropriate dosing frequency or mostly appropriate, are included. INTERVENTION: Recommendation of the appropriate dosing frequency in the prescription module. MAIN MEASUREMENTS: Adequacy defined as the coincidence between the prescribed dosing frequency and the appropriate dosing frequency. RESULTS: After the intervention there was a 22.75% increase in prescriptions with adequate dosing frequency. The largest increase occurred in the medicines for the genitourinary system and sex hormones. In absolute terms, the group of anti infective for systemic use is the one that obtained more prescriptions with an adequate dosing frequency between the two periods. CONCLUSIONS: The intervention increased the dosing frequency's adequacy leading to improvements in the safety and effectiveness of the treatments. It is evident that the design and implementation of improvements in electronic prescription systems contributes to increasing the quality of the prescription.

Characteristics of Citizens and Their Use of Teleconsultations in Primary Care in the Catalan Public Health System Before and During the COVID-19 Pandemic: Retrospective Descriptive Cross-sectional Study.

BACKGROUND: eConsulta-that is, asynchronous, two-way teleconsultation in primary care-is one of the most important telemedicine developments in the Catalan public health system, a service that has been heavily boosted by the onset of the COVID-19 pandemic. It is vital to know the characteristics of its users in order to be able to meet their needs and understand the coverage of this service in a context where there is reduced accessibility to the health system. OBJECTIVE: This study aims to analyze the profile of the citizens who use the eConsulta tool and the reasons for their use, as well as to gain an understanding of the elements that characterize their decision to use it while distinguishing between those who used it before and those who have used it since the onset of the COVID-19 pandemic. METHODS: A descriptive, observational study based on administrative data was performed. This study differentiates between the COVID-19 pandemic era and the period preceding it, considering the day the state of emergency was declared in Spain (ie, March 12, 2020) as the cut-off point. It also differentiates between eConsulta users who send messages and those who only receive them. RESULTS: During the pandemic, the number of unique users of this teleconsultation service had almost tripled, with up to 33.10 visits per 1000 inhabitants per month reported in the first three months. For the two user profiles analyzed, most users since the start of the COVID-19 outbreak were predominantly female, systematically younger, more actively employed, and with less complex pathologies. Furthermore, eConsulta users received more messages proactively from the health professionals. There was also a relative decrease in the number of conversations initiated by higher-income urban users and an increase in conversations initiated by users in rural areas. CONCLUSIONS: The COVID-19 pandemic has helped to generalize the use of telemedicine as a tool to compensate, to some extent, for the decline in face-to-face visits, especially among younger citizens in Catalonia. Telemedicine has made it possible to maintain contact between citizens and the health care system in the context of maximum complexity.

Lenguajes enfermeros estandarizados y planes de cuidados. Percepción de su empleo y utilidad en atención primaria / Standardized nursing languages and care plans. Perception of use and utility in primary healthcare

OBJETIVO: Identificar la opinión de las enfermeras de atención primaria sobre el uso y la utilidad de los planes de cuidados y los lenguajes estandarizados tradicionales en la práctica asistencial. DISEÑO: Estudio descriptivo, transversal, multicéntrico. EMPLAZAMIENTO: Equipos y dispositivos de atención primaria en Cataluña. PARTICIPANTES: Se estimó una muestra necesaria de 1.668 enfermeras y se aplicó una técnica de muestreo consecutivo. INTERVENCIONES: Cuestionario de acceso on-line con preguntas sobre la percepción de facilidad, utilidad y uso de los planes de cuidados y los lenguajes estandarizados tradicionales. Mediciones: Estadísticos descriptivos con proporciones, medidas de tendencia central y de dispersión. La significación estadística se estableció si p ≤ 0,05. RESULTADOS: Se analizaron 1.813 cuestionarios. Las participantes opinaron que los planes de cuidados tienen un valor añadido medio, aunque su uso es con frecuencia incorrecto. Refirieron un nivel de conocimientos adecuado sobre los lenguajes estandarizados, y en su mayoría (81%) opinaron que son difíciles de emplear en la práctica y que son poco útiles para representar la prestación de cuidados y sus resultados (78%). Independientemente de su nivel académico y de los años de experiencia, valoraron como insuficiente la claridad (p = 0,058), facilidad de uso (p = 0,240) y utilidad de los lenguajes estandarizados (p = 0,039). CONCLUSIONES: Las enfermeras urgen a introducir cambios en el uso de los planes de cuidados, incluyendo el cambio de lenguaje, para mejorar los datos y la información que revierta positivamente la prestación de cuidados para la mejora de los resultados de salud de las personas beneficiarias de los servicios de atención primaria

OBJECTIVE: To identify opinions of Primary Healthcare nurses on the use and usefulness of standardised nursing care plans and traditional nursing language systems in the practice settings. DESIGN: Multicentre, observational, cross-sectional study. SETTING: Primary Healthcare centres in Catalonia. PARTICIPANTS: Sample size was estimated at 1,668 registered nurses. Consecutive sampling was applied. INTERVENTIONS: On-line survey containing questions on ease, usefulness, and use of nursing care plans and standardised nursing language systems. Measurements: Descriptive statistics, including percentages, central tendency, and dispersion measures. Statistical significance was set at P ≤ .05. RESULTS: The final analysis included 1,813 questionnaires. Participants stated that care plans have a medium added value, however their use is frequently incorrect. They stated to have a fair level of knowledge on traditional standardised nursing languages, and most were of the opinion that these languages are difficult to use in practice (81%) and not useful to represent nursing care provision and its outcomes (78%). Regardless of their education level and years of experience, the participants assessed as insufficient the clarity (P = .058), ease of use (P = .240), and usefulness (P = .039) of these language systems in practice. CONCLUSIONS: Nurses say that urgent changes are required in the use of care plans. This includes changing the language systems, and improving data and information that positively impacts on the provision of nursing care, as well as to enhance the health outcomes of the individuals receiving Primary Healthcare services

[Standardized nursing languages and care plans. Perception of use and utility in primary healthcare]. / Lenguajes enfermeros estandarizados y planes de cuidados. Percepción de su empleo y utilidad en atención primaria.

OBJECTIVE: To identify opinions of Primary Healthcare nurses on the use and usefulness of standardised nursing care plans and traditional nursing language systems in the practice settings. DESIGN: Multicentre, observational, cross-sectional study. SETTING: Primary Healthcare centres in Catalonia. PARTICIPANTS: Sample size was estimated at 1,668 registered nurses. Consecutive sampling was applied. INTERVENTIONS: On-line survey containing questions on ease, usefulness, and use of nursing care plans and standardised nursing language systems. MEASUREMENTS: Descriptive statistics, including percentages, central tendency, and dispersion measures. Statistical significance was set at P≤.05. RESULTS: The final analysis included 1,813 questionnaires. Participants stated that care plans have a medium added value, however their use is frequently incorrect. They stated to have a fair level of knowledge on traditional standardised nursing languages, and most were of the opinion that these languages are difficult to use in practice (81%) and not useful to represent nursing care provision and its outcomes (78%). Regardless of their education level and years of experience, the participants assessed as insufficient the clarity (P=.058), ease of use (P=.240), and usefulness (P=.039) of these language systems in practice. CONCLUSIONS: Nurses say that urgent changes are required in the use of care plans. This includes changing the language systems, and improving data and information that positively impacts on the provision of nursing care, as well as to enhance the health outcomes of the individuals receiving Primary Healthcare services.

Comparison of the information provided by electronic health records data and a population health survey to estimate prevalence of selected health conditions and multimorbidity.

BACKGROUND: Health surveys (HS) are a well-established methodology for measuring the health status of a population. The relative merit of using information based on HS versus electronic health records (EHR) to measure multimorbidity has not been established. Our study had two objectives: 1) to measure and compare the prevalence and distribution of multimorbidity in HS and EHR data, and 2) to test specific hypotheses about potential differences between HS and EHR reporting of diseases with a symptoms-based diagnosis and those requiring diagnostic testing. METHODS: Cross-sectional study using data from a periodic HS conducted by the Catalan government and from EHR covering 80% of the Catalan population aged 15 years and older. We determined the prevalence of 27 selected health conditions in both data sources, calculated the prevalence and distribution of multimorbidity (defined as the presence of ≥2 of the selected conditions), and determined multimorbidity patterns. We tested two hypotheses: a) health conditions requiring diagnostic tests for their diagnosis and management would be more prevalent in the EHR; and b) symptoms-based health problems would be more prevalent in the HS data. RESULTS: We analysed 15,926 HS interviews and 1,597,258 EHRs. The profile of the EHR sample was 52% women, average age 47 years (standard deviation: 18.8), and 68% having at least one of the selected health conditions, the 3 most prevalent being hypertension (20%), depression or anxiety (16%) and mental disorders (15%). Multimorbidity was higher in HS than in EHR data (60% vs. 43%, respectively, for ages 15-75+, P <0.001, and 91% vs. 83% in participants aged ≥65 years, P <0.001). The most prevalent multimorbidity cluster was cardiovascular. Circulation disorders (other than varicose veins), chronic allergies, neck pain, haemorrhoids, migraine or frequent headaches and chronic constipation were more prevalent in the HS. Most symptomatic conditions (71%) had a higher prevalence in the HS, while less than a third of conditions requiring diagnostic tests were more prevalent in EHR. CONCLUSIONS: Prevalence of multimorbidity varies depending on age and the source of information. The prevalence of self-reported multimorbidity was significantly higher in HS data among younger patients; prevalence was similar in both data sources for elderly patients. Self-report appears to be more sensitive to identifying symptoms-based conditions. A comprehensive approach to the study of multimorbidity should take into account the patient perspective.

Obtaining the mean relative weights of the cost of care in Catalonia (Spain): retrospective application of the adjusted clinical groups case-mix system in primary health care.

OBJECTIVE: The study aims to obtain the mean relative weights (MRWs) of the cost of care through the retrospective application of the adjusted clinical groups (ACGs) in several primary health care (PHC) centres in Catalonia (Spain) in routine clinical practice. METHODS: This is a retrospective study based on computerized medical records. All patients attended by 13 PHC teams in 2008 were included. The principle measurements were: demographic variables (age and sex), dependent variables (number of diagnoses and total costs), and case-mix or co-morbidity variables (International Classification of Primary Care). The costs model for each patient was established by differentiating the fix costs from the variable costs. In the bivariate analysis, the Student's t, analysis of variance, chi-squared, Pearson's linear correlation and Mann-Whitney-Wilcoxon tests were used. In order to compare the MRW of the present study with those of the United States (US), the concordance [intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC)] and the correlation (coefficient of determination: R²) were measured. RESULTS: The total number of patients studied was 227,235, and the frequentation was 5.9 visits/habitant/year) and with a mean diagnoses number of 4.5 (3.2). The distribution of costs was €148.7 million, of which 29.1% were fixed costs. The mean total cost per patient/year was €654.2 (851.7), which was considered to be the reference MRW. Relationship between study-MRW and US-MRW: ICC was 0.40 [confidential interval (CI) 95%: 0.21-0.60] and the CCC was 0.42 (CI 95%: 0.35-0.49). The correlation between the US MRW and the MRW of the present study can be seen; the adjusted R² value is 0.691. The explanatory power of the ACG classification was 36.9% for the total costs. The R² of the total cost without considering outliers was 56.9%. CONCLUSIONS: The methodology has been shown appropriate for promoting the calculation of the MRW for each category of the classification. The results provide a possible practical application in PHC clinical management.

[Influenza vaccination in pregnant women. Coverage, practices and knowledge among obstetricians]. / Vacunación antigripal en gestantes. Cobertura vacunal y conocimientos y prácticas de los obstetras.

BACKGROUND AND OBJECTIVES: Women who are pregnant during influenza season have an increased risk of infection and severe clinical disease. Several national and international organizations currently recommend vaccination for pregnant women. We intended to estimate the influenza vaccination rate in a population of postpartum women attended in a tertiary hospital in Barcelona. Moreover, we assessed the knowledge and practice of obstetricians about influenza vaccination during pregnancy. METHODS: Two cross-sectional surveys were performed. Postpartum women who delivered from December 2007 to February 2008 were included. The sample of obstetricians was constituted by those who were working in hospital or primary care reference areas. RESULTS: Influenza vaccination rate was 4.1%. Healthy women represented 80.5% of our population. The vaccination rate in the group with comorbidities was 3.3%. The providers who recommended the vaccine more frequently were the midwife in 28.9% and the nurse in 18.4%. Among the obstetricians, 20.9% responded that the influenza vaccine was recommended in the first trimester of pregnancy and 65.1% said that it was recommended in the second or third trimester. In relation to practice, only 7% offered the vaccine in the first trimester and 20,9% in the second or third trimester. CONCLUSIONS: The influenza vaccination rate in pregnant women in our study is very low. Obstetricians showed a low level of knowledge about the current influenza vaccination recommendations, mainly in the case of first trimester of pregnancy and only few offered the vaccine in their practice.

[Rubella susceptibility of immigrant pregnant women in Catalonia]. / Susceptibilidad a la rubéola en gestantes inmigrantes con residencia en Cataluña.

BACKGROUND AND OBJECTIVE: Considering recent outbreaks of rubella in immigrant population in Madrid (Spain), we investigated the proportion of rubella susceptibility in immigrant women in Catalonia, Spain. PATIENTS AND METHOD: Seroprevalence study in pregnant women of the immigrant community. Information of demographic possible risk factors associated to rubella susceptibility was collected. RESULTS: Five hundred and ninety four women were included. The global prevalence of susceptibility was 11.7% (95% confidence interval [CI], 9.2-14.5%). African women showed the highest susceptibility (17%; 95% CI, 10.5-25.2%). Age younger than 25 years was a risk factor statistically associated with rubella susceptibility (adjusted odds ratio=3.02; 95% CI, 1.09-8.35). CONCLUSIONS: Rubella susceptibility in pregnant women from low income countries is 10 times higher than that of Catalonian native women.

Susceptibilidad a la rubéola en gestantes inmigrantes con residencia en Cataluña / Rubella susceptibility of immigrant pregnant women in Catalonia

Fundamento y objetivo: tras los recientes brotes de rubéola descritos en población inmigrante de Madrid, se ha querido conocer la proporción de mujeres inmigrantes susceptibles a esta enfermedad en Cataluña. Pacientes y método: se ha llevado a cabo un estudio de seroprevalencia en mujeres gestantes provenientes de países de renta baja. Se recogió información demográfica y sobre posibles factores predictivos de susceptibilidad. Resultados: se incluyó en el estudio a 594 mujeres. La proporción global de susceptibilidad a la rubéola fue del 11,7% (intervalo de confianza [IC] del 95%, 9,2–14,5%). La mayor prevalencia de susceptibles se observó en las mujeres de origen africano (17%; IC del 95%, 10,5–25,2%). La edad inferior a 25 años fue un factor de riesgo asociado a la susceptibilidad a la rubéola (odds ratio ajustada=3,02; IC del 95%, 1,09–8,35). Conclusiones: el porcentaje de susceptibilidad a la rubéola entre las gestantes provenientes de países de renta baja supera en 10 veces la susceptibilidad de las mujeres en edad fértil autóctonas de Cataluña (AU)

Background and objective: Considering recent outbreaks of rubella in immigrant population in Madrid (Spain), we investigated the proportion of rubella susceptibility in immigrant women in Catalonia, Spain. Patients and method: Seroprevalence study in pregnant women of the immigrant community. Information of demographic possible risk factors associated to rubella susceptibility was collected. Results: Five hundred and ninety four women were included. The global prevalence of susceptibility was 11.7% (95% confidence interval [CI], 9.2–14.5%). African women showed the highest susceptibility (17%; 95% CI, 10.5–25.2%). Age younger than 25 years was a risk factor statistically associated with rubella susceptibility (adjusted odds ratio=3.02; 95% CI, 1.09–8.35). Conclusions: Rubella susceptibility in pregnant women from low income countries is 10 times higher than that of Catalonian native women (AU)

[Polymyositis-dermatomyositis: incidence in Spain (1997-2004)]. / Polimiositis y dermatomiositis: incidencia en España (1997-2004).

BACKGROUND AND OBJECTIVE: Epidemiologic studies of polymyositis-dermatomyositis incidence in Spain are lacking. The aim of the study was to determine the incidence rates of dermatomyositis-polymyositis and their distribution in our country. MATERIAL AND METHOD: Observational and descriptive study. Data was obtained from hospital discharge code (CMBD) during the period 1997-2004. Sex, region and age were analysed. Raw and standardized incidence rates for each region studied were calculated as new cases/million population/year with 95% confidence interval (CI). Trend odds ratio (OR) was calculated by means of a logistic regression. RESULTS: Global incidence rate in polymyositis-dermatomyositis was 8.9 new cases/million population/year (CI 95%, 8.6-9.2); 3.9 (CI 95%, 3.7-4.1) for polymyositis and 4.9 (CI 95%, 4.7-5.2) for dermatomyositis. Rate differences between both diseases reached statistical significance (p < 0.001). Annual incidence rate decreased significantly across the period studied in both diseases with a trend OR of 0.95 (CI 95%, 0.93-0.97; p < 0.001) in dermatomyositis and 0.96 (CI 95%, 0.93-0.97; p < 0.001) in polymyositis. Both diseases were significantly more frequent in females (p < 0.001). The incidence rates for each region varies between 2.2 and 10.6 cases/million population/year in polymyositis and between 2.9 and 8.6 cases/million population/year in dermatomyositis. CONCLUSIONS: Incidence of dermatomyositis-polymyositis in Spain is similar to other countries. Decreased incidence observed across the period and the higher incidence of dermatomyositis could be explained because of a better diagnosis of these entities.

Polimiositis y dermatomiositis: incidencia en España (1997-2004) / Polymyositis-dermatomyositis: incidence in Spain (1997-2004)

Fundamento y objetivo: No existen estudios epidemiológicos sobre la incidencia de miopatía inflamatoria en España. El objetivo de este estudio fue determinar las tasas de incidencia de dermatomiositis y polimiositis y su distribución en el territorio español. Material y método: Estudio descriptivo observacional a partir de los datos del Conjunto Mínimo Básico de Datos de Altas Hospitalarias en el período 1997-2004. Se analizaron las variables sexo, comunidad autónoma y edad. Se calcularon las tasas de incidencia de hospitalización en casos por millón de habitantes y año brutas y estandarizadas y su intervalo de confianza (IC) del 95%, en total y por comunidad autónoma. Para el análisis de tendencia del período estudiado, se calculó la odds ratio (OR) de tendencia mediante regresión logística. Resultados: La tasa de incidencia total del conjunto de dermatomiositis y polimiositis fue de 8,9 (IC del 95%, 8,6-9,2) nuevos casos por millón de habitantes y año; la de polimiositis, 3,9 (IC del 95%, 3,7-4,1), y la dermatomiositis, 4,9 (IC del 95%, 4,7-5,2). La diferencia entre las tasas de ambas enfermedades fue estadísticamente significativa (p < 0,001). La tasa de incidencia anual de ambas enfermedades disminuyó de forma significativa durante el período (dermatomiositis, OR de tendencia = 0,95; IC del 95%, 0,93-0,97; p < 0,001; polimiositis, OR = 0,96; IC del 95%, 0,93-0,97; p < 0,001). La incidencia de ambas enfermedades fue significativamente superior en mujeres. Las tasas de incidencia de polimiositis oscilaban en las diferentes comunidades autónomas entre 2,2 y 10,6 casos por millón de habitantes y año y las de la dermatomiositis, entre 2,9 y 8,6 casos por habitantes y año. Conclusiones: La incidencia de dermatomiositis y polimiositis en España es similar a la observada en otras zonas del mundo. La disminución de la incidencia mantenida a lo largo del período y la incidencia más alta de dermatomiositis podrían explicarse por una mejor categorización de estas enfermedades

Background and objective: Epidemiologic studies of polymyositis-dermatomyositis incidence in Spain are lacking. The aim of the study was to determine the incidence rates of dermatomyositis-polymyositis and their distribution in our country. Material and method: Observational and descriptive study. Data was obtained from hospital discharge code (CMBD) during the period 1997-2004. Sex, region and age were analysed. Raw and standardized incidence rates for each region studied were calculated as new cases/million population/year with 95% confidence interval (CI). Trend odds ratio (OR) was calculated by means of a logistic regression. Results: Global incidence rate in polymyositis-dermatomyositis was 8.9 new cases/million population/year (CI 95%, 8.6-9.2); 3.9 (CI 95%, 3.7-4.1) for polymyositis and 4.9 (CI 95%, 4.7-5.2) for dermatomyositis. Rate differences between both diseases reached statistical significance (p < 0.001). Annual incidence rate decreased significantly across the period studied in both diseases with a trend OR of 0.95 (CI 95%, 0.93-0.97; p < 0.001) in dermatomyositis and 0.96 (CI 95%, 0.93-0.97; p < 0.001) in polymyositis. Both diseases were significantly more frequent in females (p < 0.001). The incidence rates for each region varies between 2.2 and 10.6 cases/million population/year in polymyositis and between 2.9 and 8.6 cases/million population/year in dermatomyositis. Conclusions: Incidence of dermatomyositis-polymyositis in Spain is similar to other countries. Decreased incidence observed across the period and the higher incidence of dermatomyositis could be explained because of a better diagnosis of these entities

An approach to the study of potentially preventable nosocomial infections.

OBJECTIVE: To analyze a method that identifies potentially preventable nosocomial infections, as a tool to evaluate the performance of infection control programs through quantification of their potential for reducing nosocomial infections. METHODS: The database of the Study of the Prevalence of Nosocomial Infections in Spain (EPINE) was reanalyzed. The method was based on the use of false negatives of the classification table obtained from application of a fixed multiple logistic regression model, as an estimator of the number of potentially preventable nosocomial infections. RESULTS: The calculated number of patients with preventable infections was 7,493, which constituted 21.6% of the infected patients. Among hospital areas, intensive care had the lowest preventability rate (4.6%), whereas gynecology and obstetrics had the highest (40.6%). There was a significant inverse exposure-effect relationship between the proportion of preventable infections and the National Nosocomial Infections Surveillance (NNIS) System risk index. No correlation was observed between the prevalence of patients with nosocomial infection and the percentage of preventable infections. CONCLUSION: This analysis suggests that fewer nosocomial infections may be preventable in Spanish hospitals than previously assumed.