Cargando…
Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol
BACKGROUND: Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2008
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533323/ https://www.ncbi.nlm.nih.gov/pubmed/18691407 http://dx.doi.org/10.1186/1471-2458-8-281 |
_version_ | 1782159030414737408 |
---|---|
author | Bolíbar, Bonaventura Pareja, Clara Astier-Peña, M Pilar Morán, Julio Rodríguez-Blanco, Teresa Rosell-Murphy, Magdalena Iglesias, Manuel Juncosa, Sebastián Mascort, Juanjo Violan, Concepció Magallón, Rosa Apezteguia, Javier |
author_facet | Bolíbar, Bonaventura Pareja, Clara Astier-Peña, M Pilar Morán, Julio Rodríguez-Blanco, Teresa Rosell-Murphy, Magdalena Iglesias, Manuel Juncosa, Sebastián Mascort, Juanjo Violan, Concepció Magallón, Rosa Apezteguia, Javier |
author_sort | Bolíbar, Bonaventura |
collection | PubMed |
description | BACKGROUND: Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of 7 preventive services (screening for smoking status, alcohol abuse, hypertension, hypercholesterolemia, obesity, influenza and tetanus immunization) and to determine their related factors; 2) To describe the degree of control of 5 identified health problems (smoking, alcohol abuse, hypertension, hypercholesterolemia and obesity); 3) To calculate intraclass correlation coefficients. DESIGN: Multi-centered cross-sectional study of a randomised sample of primary health care teams from 3 regions of Spain designed to analyse variability and related factors of 7 selected preventive services in years 2006 and 2007. At the end of 2008, we will perform a cross-sectional study of a cohort of patients attended in 2006 or 2007 to asses the degree of control of 5 identified health problems. All subjects older than16 years assigned to a randomised sample of 22 computerized primary health care teams and attended during the study period are included in each region providing a sample with more than 850.000 subjects. The main outcome measures will be implementation of 7 preventive services and control of 5 identified health problems. Furthermore, there will be 3 levels of data collection: 1) Patient level (age, gender, morbidity, preventive services, attendance); 2) Health-care professional level (professional characteristics, years working at the team, workload); 3) Team level (characteristics, electronic clinical record system). Data will be transferred from electronic clinical records to a central database with prior encryption and dissociation of subject, professional and team identity. Global and regional analysis will be performed including standard analysis for primary health care teams and health-care professional level. Linear and logistic regression multilevel analysis adjusted for individual and cluster variables will also be performed. Variability in the number of preventive services implemented will be calculated with Poisson multilevel models. Team and health-care professional will be considered random effects. Intraclass correlation coefficients, standard error and variance components for the different outcome measures will be calculated. |
format | Text |
id | pubmed-2533323 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-25333232008-09-11 Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol Bolíbar, Bonaventura Pareja, Clara Astier-Peña, M Pilar Morán, Julio Rodríguez-Blanco, Teresa Rosell-Murphy, Magdalena Iglesias, Manuel Juncosa, Sebastián Mascort, Juanjo Violan, Concepció Magallón, Rosa Apezteguia, Javier BMC Public Health Study Protocol BACKGROUND: Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of 7 preventive services (screening for smoking status, alcohol abuse, hypertension, hypercholesterolemia, obesity, influenza and tetanus immunization) and to determine their related factors; 2) To describe the degree of control of 5 identified health problems (smoking, alcohol abuse, hypertension, hypercholesterolemia and obesity); 3) To calculate intraclass correlation coefficients. DESIGN: Multi-centered cross-sectional study of a randomised sample of primary health care teams from 3 regions of Spain designed to analyse variability and related factors of 7 selected preventive services in years 2006 and 2007. At the end of 2008, we will perform a cross-sectional study of a cohort of patients attended in 2006 or 2007 to asses the degree of control of 5 identified health problems. All subjects older than16 years assigned to a randomised sample of 22 computerized primary health care teams and attended during the study period are included in each region providing a sample with more than 850.000 subjects. The main outcome measures will be implementation of 7 preventive services and control of 5 identified health problems. Furthermore, there will be 3 levels of data collection: 1) Patient level (age, gender, morbidity, preventive services, attendance); 2) Health-care professional level (professional characteristics, years working at the team, workload); 3) Team level (characteristics, electronic clinical record system). Data will be transferred from electronic clinical records to a central database with prior encryption and dissociation of subject, professional and team identity. Global and regional analysis will be performed including standard analysis for primary health care teams and health-care professional level. Linear and logistic regression multilevel analysis adjusted for individual and cluster variables will also be performed. Variability in the number of preventive services implemented will be calculated with Poisson multilevel models. Team and health-care professional will be considered random effects. Intraclass correlation coefficients, standard error and variance components for the different outcome measures will be calculated. BioMed Central 2008-08-08 /pmc/articles/PMC2533323/ /pubmed/18691407 http://dx.doi.org/10.1186/1471-2458-8-281 Text en Copyright © 2008 Bolíbar et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Study Protocol Bolíbar, Bonaventura Pareja, Clara Astier-Peña, M Pilar Morán, Julio Rodríguez-Blanco, Teresa Rosell-Murphy, Magdalena Iglesias, Manuel Juncosa, Sebastián Mascort, Juanjo Violan, Concepció Magallón, Rosa Apezteguia, Javier Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol |
title | Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol |
title_full | Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol |
title_fullStr | Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol |
title_full_unstemmed | Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol |
title_short | Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol |
title_sort | variability in the performance of preventive services and in the degree of control of identified health problems: a primary care study protocol |
topic | Study Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533323/ https://www.ncbi.nlm.nih.gov/pubmed/18691407 http://dx.doi.org/10.1186/1471-2458-8-281 |
work_keys_str_mv | AT bolibarbonaventura variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT parejaclara variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT astierpenampilar variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT moranjulio variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT rodriguezblancoteresa variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT rosellmurphymagdalena variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT iglesiasmanuel variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT juncosasebastian variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT mascortjuanjo variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT violanconcepcio variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT magallonrosa variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol AT apezteguiajavier variabilityintheperformanceofpreventiveservicesandinthedegreeofcontrolofidentifiedhealthproblemsaprimarycarestudyprotocol |