ABSTRACT
OBJECTIVES: To find the views of family doctors (FD) on care demand, its conditioning factors, its repercussions and possible rationalizing measures, and to relate these to personal and professional characteristics. DESIGN: A descriptive crossover study. SETTING: Primary care. PARTICIPANTS: 140 of 262 FD from Health Centres in Navarra who responded to a self-filled questionnaire. MEASUREMENTS AND RESULTS: The doctors stated they averaged 31.3 patients per day (SD = 14.3) and thought that the ideal was 21.2 (SD = 9.6). 69.2% attendances were unjustified. 57.7% considered the volume of demand obstructed other health activities: teaching (50%) and research (52.9%) were the activities most obstructed, and professional satisfaction (41.4%) the personal aspect most affected. CONCLUSIONS: A high percentage of those surveyed think that there is excessive care pressure with affects other activities and the welfare and relationships of the FDs. Among measures aimed at rationalizing health-care demand, the development of nursing activity and coordination of care levels must be considered.
Subject(s)
Attitude of Health Personnel , Health Services Needs and Demand , Physicians, Family/psychology , Adult , Analysis of Variance , Cross-Sectional Studies , Female , Health Services Needs and Demand/statistics & numerical data , Humans , Male , Middle Aged , Physicians, Family/statistics & numerical data , Spain , Statistics, Nonparametric , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To find the utilization of the health center medical services in Navarra and how it relates to characteristics of both doctors and population. DESIGN: Descriptive study. SETTING: Primary Health Care. PARTICIPANTS: 167 family doctors (GP) from 31 PCTs. The daily on-demand, administrative and pre-programmed consultation in the records of the PCTs from 1/5/90 to 30/3/91 were analysed for each doctor. MEASUREMENTS AND RESULTS: Indicators: frequentation (interviews/inhabitant/year), pressure of attendance (interviews/doctor/day), programmed pressure (pre-programmed interviews/doctor/day) and administrative pressure (administrative interviews/doctor/day). Average frequency in Navarra is 5.26 (SD = 2.58); average pressure of attendance, 32.13 (SD = 11.88); average pre-programmed pressure, 2.68 (SD = 1.81) and average administrative pressure, 7.9 (SD = 7.11). Frequency is inversely determined by the size of the allotted population list (p < 0.01). On studying doctors with an allotted list of _ 1,500 people, GPs with residential training have lower frequency of interviews than the rest (p < 0.01), whereas rural GPs have higher frequency and higher pressure of attendance (p < 0.001). Rural areas in the North of Navarra have a lower frequency of interviews and pressure of attendance than rural areas in the South (p < 0.02). CONCLUSION: Values of frequency in Navarra are comparable with other countries.
