Perfil de uso de recursos y costes en pacientes que demandan atención por fibromialgia o trastorno de ansiedad generalizada en el ámbito de la atención primaria de salud

Abstract

Objective To determine the use of services and costs in patients with Fibromyalgia (FM) or Generalized Anxiety Disorder (GAD) followed up in Primary Care (PC). Design A retrospective multicenter population-based study. Setting Five primary care clinics managed by Badalona Health Service. Participants Patients over 18 years seen in the 5 PC centers during the year 2006. Patients with and without GAD/FM were compared. Measurements Main outcomes measures were general, case/co-morbidity, health care use and primary care cost (visits, diagnostic/therapeutic tests and drugs). Statistical analysis: logistic regression and ANCOVA ( P<.05). Results There was a total of 63,349 patients, 1.4% (95% CI, 0.6%–2.2%) had a diagnosis of FM, and 5.3% (95% CI, 4.5%–6.1%) GAD. The average episodes/year and visits /year was higher in FM group compared to GAD group, with a marked difference observed vs. the reference group (8.3 vs. 7.2 and 4.6 episodes/year; and 12.9 vs. 12.1 and 7.4 visits/year; P<.001). FM was shown to be related to female gender (odds ratio [OR]=16.8), dyslipidemia (OR=1.5), and depressive syndrome (OR=3.9) ( P<.001 in all cases). GAD was related to age (OR=1.1), female gender (OR=2.2), high blood pressure (OR=1.3), dyslipidemia (OR=1.2), smoking (OR=1.4), depressive syndrome (OR=1.2), and cardiovascular events (OR=1.3) ( P<.02 in all cases). After adjusting for age, gender and co-morbidities, mean annual direct ambulatory cost was 555.58€ for the reference group, 817.37€ for GAD, and 908.67€ for FM ( P<.001). Conclusions Compared with reference group, a considerable use of health resources and costs was observed in patients with FM or TAG in medical practice in PC settings.