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A Brugos Larumbe

Publications and source records attributed to A Brugos Larumbe.

5 recordsLinked to original sources

[Models to explain and predict medical case-loads: their use in calculating the maximum family medicine list that allows at least ten minutes per consultation].

OBJECTIVE: To calculate the maximum family medicine list that gives at least ten minutes per consultation.Design. Transversal. SETTING: Three health centres. SUBJECTS: 45 826 inhabitants. MEASUREMENTS: We used the appointments made at three centres to calculate the annual time employed per patient and we adjusted it to allocate a minimum of ten minutes per consultation. We established a cubic regression model to predict the mean case-load per age of patient in general medicine and calculated the maximum list if 70% of the working day were dedicated to care. The results contrasted two centres with greater nursing involvement and one with less. We showed the R2 coefficients. We calculated the maximum lists for the health centres of Navarra and showed them in five clusters worked out on the basis of the percentage of patients >=65. RESULTS: Age explained 86.1% of variability in mean case-load at each age (84% in children and 93.5% in adults). According to the mean percentage of those >=65 years old, the average maximum lists for centres with more or less nursing involvement are as follows: 7.0%>=65 (2025 and 1989); 14.0% (1834 and 1715); 21.2% (1691 and 1558); 27.0% (1648 and 1460), 34.0% (1560 and 1340). CONCLUSION: To a great extent, age explains the variability in case-load and lets us calculate the maximum number of patients on the list that still ensures a minimum time for each consultation.

Adult↗

[A proposal for capitation payment, based on age, chronicity, and gender, using management databases].

OBJECTIVES: To propose a case-mix methodology for primary care, based on chronicity, type and age. To describe the explanatory value of these variables in the variability of the medical case-load. DESIGN: Observation, descriptive and retrospective study. SETTING: Primary care. Rochapea Health Centre, Pamplona. MATERIAL AND METHODS: Computer records of all the consultations between January 1996 and June 1997. Dependent variable: case-load. INDEPENDENT VARIABLES: age, type, chronic pathologies (diabetes, lipaemia, chronic neurological diseases, COPD-asthma, chronic psychiatric illnesses, cardiopathy, hypertension, alcohol and other drug abuse). The Kruskal-Wallis test was used to compare work-loads by age groups; and multiple linear regression analysis to calculate the predictive power of the independent variables. RESULTS: Significant differences were observed for age groups. In the multivariate model used for general practitioners, all the variables could be included. They explained 24.2% of the variability in work load (R2). For paediatricians, age and asthma, explaining 23.48%, could also be included. CONCLUSIONS: Age, type and chronicity are useful variables for predicting case load from administrative data bases. They can be used in adjustments for case load applicable to capitation payment systems.

Adolescent↗

[Risk of pregnancy in adolescence].

OBJECTIVE: To describe the frequency and distribution of sexual conduct with risk of pregnancy, the degree of information on sexuality and contraceptive methods. To analyze the relationship between sexual conduct with risk of pregnancy and the most relevant variables of social surroundings of the adolescent: family, friends, school, etc. DESIGN: Descriptive survey by means of a questionnaire. LOCATION: Basic Neighbourhood Health Zone (Gran Canaria). TARGET GROUP: Teenage students aged between 14 and 19. Measurements and main results 21% of the population in the survey have sexual relationships, and out of these, 88% run a high risk of becoming pregnant. The information they have is basically theoretical, and practical knowledge is low. Older adolescents (OR, 1,4/year), males (OR 2.08), those with parents with no qualifications (OR 1.88) and those with parents of a high income bracket (OR 4.11) have the most high-risk sexual relationships. CONCLUSIONS: The importance of high-risk sexual conduct in adolescence is underlined, plus the need for information of adolescents, although it does not seem enough, in order to face sexuality with guarantees.

Adolescent↗