Tamaño del cupo e importe, intensidad y calidad de la prescripción de los médicos de familia

Abstract

Objectives To determine the relationship between some characteristics (cost, intensity, quality) of prescriptions issued by general practitioners in a health district and their patient loads, controlling for possible confounders. To analyze the intensity of prescription of certain groups of therapeutic drugs according to the patient load. Design Quantitative study of consumption of medicines. Setting Health District n° 20 of the Valencian Health Agency. Participants All patients on the lists of general practitioners ( n=122) in the reformed model of primary healthcare in the Health District in 2007. Measurements and results All official prescriptions issued in 2007 to patients on the 122 lists were analysed. We defined variables relating to the patient load and the cost, intensity and quality of the prescription. The relationship between patient load and prescription characteristics was analysed, adjusting for possible confounders. The intensity of prescription of the 35 most representative groups of therapeutic drugs (81% of prescriptions) was analysed according to patient load. With statistical significance, a lower prescription cost by person (beta=−0,22) and by prescription (beta=−0,26),was found in active patients of the largest patient loads and a lower intensity of prescription of some drugs groups such as antihypertensives ( r=−0.23), antidiabetics ( r=−0.29) and antiaggregates ( r=−0.19). Conclusions We put forward the hypothesis that the active patients in the largest patient loads may be under-diagnosed or undertreated for certain disorders, such as hypertension, diabetes mellitus, or the prevention of cardiovascular risk, thereby contributing to the lower prescription cost in such patient loads.