Variaciones en el consumo de recursos de atención primaria por niños menores de 7 años en los medios rural y urbano. Estudio de cohortes

Abstract

[corrected] To describe differences between two health districts in primary care resource use. Retrospective population cohort study. A rural healthdistrict (RD) and an urban health district (UD). A cohort of children born in 1991 in a UD (n=104) and a cohort of children born in 1991 and 1992 in an RD (n=88), registered in their primary care centres between 0 and 6 years old. Attention episodes, requested visits, practicioner programmed visits, nursery programmed visits and diagnosis tests. Significative differences were noticed in the attention episode average(ZU=34.0; 95% CI, 31.5%-36.5%); (ZR=25.6; 95% CI, 22.7%-28.5%), in requested visits (ZU=45.8; 95% CI, 41.8%-49.9%); (ZR=28.8; 95% CI, 25.3%-31.9%), in practicioner programmed visits (ZU=7.1; 95% CI, 6.6%-7.5%), (ZR=11.2; 95% CI, 10.7%-11.7%) and in nursery programmed visits (ZU=9.8; 95% CI, 9.0%-10.6%) (ZR=12.0; 95% CI, 11.4%-12.5%). At least one diagnosis test was applied to 90.3% of children in the UD and to 64.8% of children in the RD; and in the UD for each attention episode 1.32 (95% CI, 1.28%-1.36%) requested visits were attended to and 0.2 (95% CI, 0.17%-0.23%) diagnosis tests were made; whereas in the RD 1.1 (95% CI, 1.08%-1.13%) requested visits and 0.09 (95% CI, 0.06%-0.12%) diagnosis tests. In both health districts the average of attention episodes, requested visits and tests was significantly higher in children who had been hospitalized. Primary care services utilization and the number of diagnosis test and attention episode visits are higher in the urban district than in the rural one.