¿Es la cartera de servicios un instrumento útil para la asignación de recursos farmacéuticos en atención primaria?

Abstract

To find whether in certain primary care teams an association exists between the level of coverage in determined services and expenditure on drugs for pathologies included in these services. Retrospective descriptive study. Primary care, INSALUD, Area 1, Huesca. Using the data on coverage of the service portfolio in 1999 and pharmacy expenditure by therapeutic sub-groups during January-October of the same year, the following was analysed:- The service caring for chronic patients: Hypercholesterolaemia and comparison with expenditure in sub-group B04A (lipid-lowerers/ anti-atheroma drugs).- The service caring for chronic patients: Diabetes and comparison with expenditure in sub-groups A10A (insulin) and A10B (oral antidiabetic drugs). Expenditure was expressed as cost adjusted per 100 insured persons, using the INSALUD coefficients for the adjustment (active person coefficient: 0.732; pensioner coefficient: 0.268). The relationship between the two variables was represented graphically by a cloud of dots. Association between them was measured by Pearson's correlation coefficient. No statistically significant correlation was found between coverage and pharmacy expenditure in these sub-groups. Hypercholesterolaemia/lipid-lowerers: Pearson's coefficient = 0.334, 95% CI (-0.115 to 0.669). Diabetes/oral diabetic drugs and insulin: Pearson's coefficient < 0.1. The differences in coverage of the services analysed bear no direct relationship to pharmacy expenditure. The portfolio of services is not a good method of allocation of pharmaceutical resources.