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Heart failure in primary care: co-morbidity and utilization of health care resources

BACKGROUND. In order to ensure proper management of primary care (PC) services, the efficiency of the health professionals tasked with such services must be known. Patients with heart failure (HF) are characterized by advanced age, high co-morbidity and high resource utilization. OBJECTIVE. To ascer...

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Autores principales: Carmona, Montserrat, García-Olmos, Luis M, García-Sagredo, Pilar, Alberquilla, Ángel, López-Rodríguez, Fernando, Pascual, Mario, Muñoz, Adolfo, Salvador, Carlos H, Monteagudo, José L, Otero-Puime, Ángel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782063/
https://www.ncbi.nlm.nih.gov/pubmed/23776041
http://dx.doi.org/10.1093/fampra/cmt024
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author Carmona, Montserrat
García-Olmos, Luis M
García-Sagredo, Pilar
Alberquilla, Ángel
López-Rodríguez, Fernando
Pascual, Mario
Muñoz, Adolfo
Salvador, Carlos H
Monteagudo, José L
Otero-Puime, Ángel
author_facet Carmona, Montserrat
García-Olmos, Luis M
García-Sagredo, Pilar
Alberquilla, Ángel
López-Rodríguez, Fernando
Pascual, Mario
Muñoz, Adolfo
Salvador, Carlos H
Monteagudo, José L
Otero-Puime, Ángel
author_sort Carmona, Montserrat
collection PubMed
description BACKGROUND. In order to ensure proper management of primary care (PC) services, the efficiency of the health professionals tasked with such services must be known. Patients with heart failure (HF) are characterized by advanced age, high co-morbidity and high resource utilization. OBJECTIVE. To ascertain PC resource utilization by HF patients and variability in the management of such patients by GPs. METHODS. Descriptive, cross-sectional study targeting a population attended by 129 GPs over the course of 1 year. All patients with diagnosis of HF in their clinical histories were included, classified using the Adjusted Clinical Group system and then grouped into six resource utilization bands (RUBs). Resource utilization and Efficiency Index were both calculated. RESULTS. One hundred per cent of patients with HF were ranked in RUBs 3, 4 and 5. The highest GP visit rate was 20 and the lowest in excess of 10 visits per year. Prescription drug costs for these patients ranged from €885 to €1422 per patient per year. Health professional efficiency varied notably, even after adjustment for co-morbidity (Efficiency Index Variation Ratio of 28.27 for visits and 404.29 for prescription drug cost). CONCLUSIONS. Patients with HF register a high utilization of resources, and there is great variability in the management of such patients by health professionals, which cannot be accounted for by the degree of case complexity.
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spelling pubmed-37820632014-10-01 Heart failure in primary care: co-morbidity and utilization of health care resources Carmona, Montserrat García-Olmos, Luis M García-Sagredo, Pilar Alberquilla, Ángel López-Rodríguez, Fernando Pascual, Mario Muñoz, Adolfo Salvador, Carlos H Monteagudo, José L Otero-Puime, Ángel Fam Pract Original Article BACKGROUND. In order to ensure proper management of primary care (PC) services, the efficiency of the health professionals tasked with such services must be known. Patients with heart failure (HF) are characterized by advanced age, high co-morbidity and high resource utilization. OBJECTIVE. To ascertain PC resource utilization by HF patients and variability in the management of such patients by GPs. METHODS. Descriptive, cross-sectional study targeting a population attended by 129 GPs over the course of 1 year. All patients with diagnosis of HF in their clinical histories were included, classified using the Adjusted Clinical Group system and then grouped into six resource utilization bands (RUBs). Resource utilization and Efficiency Index were both calculated. RESULTS. One hundred per cent of patients with HF were ranked in RUBs 3, 4 and 5. The highest GP visit rate was 20 and the lowest in excess of 10 visits per year. Prescription drug costs for these patients ranged from €885 to €1422 per patient per year. Health professional efficiency varied notably, even after adjustment for co-morbidity (Efficiency Index Variation Ratio of 28.27 for visits and 404.29 for prescription drug cost). CONCLUSIONS. Patients with HF register a high utilization of resources, and there is great variability in the management of such patients by health professionals, which cannot be accounted for by the degree of case complexity. Oxford University Press 2013-10 2013-06-17 /pmc/articles/PMC3782063/ /pubmed/23776041 http://dx.doi.org/10.1093/fampra/cmt024 Text en © The Author 2013. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Carmona, Montserrat
García-Olmos, Luis M
García-Sagredo, Pilar
Alberquilla, Ángel
López-Rodríguez, Fernando
Pascual, Mario
Muñoz, Adolfo
Salvador, Carlos H
Monteagudo, José L
Otero-Puime, Ángel
Heart failure in primary care: co-morbidity and utilization of health care resources
title Heart failure in primary care: co-morbidity and utilization of health care resources
title_full Heart failure in primary care: co-morbidity and utilization of health care resources
title_fullStr Heart failure in primary care: co-morbidity and utilization of health care resources
title_full_unstemmed Heart failure in primary care: co-morbidity and utilization of health care resources
title_short Heart failure in primary care: co-morbidity and utilization of health care resources
title_sort heart failure in primary care: co-morbidity and utilization of health care resources
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782063/
https://www.ncbi.nlm.nih.gov/pubmed/23776041
http://dx.doi.org/10.1093/fampra/cmt024
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