RESUMO
INTRODUCCIÓN: Los grupos de morbilidad ajustados (GMA) están siendo utilizados en la estratificación de los pacientes crónicos en atención primaria (AP). El objetivo del estudio fue describir las características, prevalencia de comorbilidades y utilización de servicios en AP de los pacientes crónicos pediátricos y analizar factores asociados al peso de complejidad según GMA. PACIENTES Y MÉTODOS: Estudio observacional descriptivo transversal. Se incluyeron los pacientes<18 años de una zona básica de salud clasificados como crónicos según los GMA de la historia clínica electrónica de AP de la Comunidad de Madrid. Se recogieron variables sociodemográficas, clínico-asistenciales y de uso de servicios en AP. Análisis univariado, bivariado y regresión lineal. RESULTADOS: De los 2.961 pacientes<18 años se identificaron como crónicos 423 (15,7%), de los que 408 (96,5%) eran de bajo riesgo. Su edad media fue 9,5 (DE=4,7) años y el 54,1% eran varones. La media de enfermedades crónicas fue 1,1 (DE=0,4) y el 11,3% tenían multimorbilidad. Las enfermedades más prevalentes fueron: asma (6,1%), trastorno por déficit de atención e hiperactividad (TDAH) (1,8%) y obesidad (1,4%). La media de visitas/año al pediatra fue 4,9 (DE=6,3). Se asoció a mayor peso de complejidad la edad<5 años (coeficiente B [CB]=2,6; IC 95%=2,1; 3,1), número de enfermedades crónicas (CB=1,6; IC 95%=1,1; 2,1) y contactos anuales con AP (CB=0,1; IC 95%=0,06;0,11). CONCLUSIONES: En población pediátrica encontramos un número importante de pacientes con enfermedades crónicas, siendo el asma, el TDAH y la obesidad las enfermedades más prevalentes. El uso de servicios de AP fue elevado. La mayor complejidad responde a la edad lactante y la preescolar, a la multimorbilidad y a los mayores contactos con AP
INTRODUCTION: Adjusted morbidity groups (AMG) are being used in the stratification of chronic patients in Primary Care (PC). The aim of this study was to describe the characteristics, prevalence of comorbidities, and use of PC services by chronic paediatric patients as well as to analyse factors associated with the weight of complexity according to AMG. PATIENTS AND METHODS: A cross-sectional study conducted on patients <18 years-old from a basic health area, classified as chronic according to the AMG of the Madrid Primary Care computerised clinical records. Sociodemographic and clinical-care variables were collected, as well as the use of services in PC. Univariate, bivariate and linear regression analysis were performed. RESULTS: A total of 2,961 patients<18 years were included, of whom 423 (15.7%) were identified as chronic, and 408 (96.5%) were low risk patients. Their mean age was 9.5 (SD=4.7) years, and 54.1% were male. The mean of chronic diseases was 1.1 (SD=0.4) and 11.3% had multiple morbidity. The most prevalent diseases were asthma (6.1%), attention deficit hyperactivity disorder (ADHD) (1.8%), and obesity (1.4%). The mean number of visits to the paediatrician was 4.9 (SD=6.3). Age<5 years-old (Coefficient B [CB]=2.6, 95% CI=2.1, 3.1), number of chronic diseases (CB=1.6, 95% CI=1.1; 2.1), and annual contacts with PC (CB=0.1, 95% CI=0.06; 0.11) were associated with greater complexity weight. CONCLUSIONS: A significant number of patients with chronic diseases were found in the paediatric population. The most prevalent diseases were asthma, ADHD, and obesity. The use of PC services was high. The greatest complexity corresponded to nursing and pre-school age, multiple morbidity, and higher number of contacts with PC
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Doença Crônica/epidemiologia , Atenção Primária à Saúde , Doença Crônica/mortalidade , Comorbidade , Indicadores de Morbimortalidade , Estudos Transversais , Modelos Lineares , Serviços de Saúde da CriançaRESUMO
INTRODUCTION: Adjusted morbidity groups (AMG) are being used in the stratification of chronic patients in Primary Care (PC). The aim of this study was to describe the characteristics, prevalence of comorbidities, and use of PC services by chronic paediatric patients as well as to analyse factors associated with the weight of complexity according to AMG. PATIENTS AND METHODS: A cross-sectional study conducted on patients <18 years-old from a basic health area, classified as chronic according to the AMG of the Madrid Primary Care computerised clinical records. Sociodemographic and clinical-care variables were collected, as well as the use of services in PC. Univariate, bivariate and linear regression analysis were performed. RESULTS: A total of 2,961 patients<18 years were included, of whom 423 (15.7%) were identified as chronic, and 408 (96.5%) were low risk patients. Their mean age was 9.5 (SD=4.7) years, and 54.1% were male. The mean of chronic diseases was 1.1 (SD=0.4) and 11.3% had multiple morbidity. The most prevalent diseases were asthma (6.1%), attention deficit hyperactivity disorder (ADHD) (1.8%), and obesity (1.4%). The mean number of visits to the paediatrician was 4.9 (SD=6.3). Age<5 years-old (Coefficient B [CB]=2.6, 95% CI=2.1, 3.1), number of chronic diseases (CB=1.6, 95% CI=1.1; 2.1), and annual contacts with PC (CB=0.1, 95% CI=0.06; 0.11) were associated with greater complexity weight. CONCLUSIONS: A significant number of patients with chronic diseases were found in the paediatric population. The most prevalent diseases were asthma, ADHD, and obesity. The use of PC services was high. The greatest complexity corresponded to nursing and pre-school age, multiple morbidity, and higher number of contacts with PC.
