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A Guarga Rojas

Publications and source records attributed to A Guarga Rojas.

13 recordsLinked to original sources
PubMed2005

[Results of a benchmarking exercise for primary care teams in Barcelona, Spain].

OBJECTIVE: To identify primary care teams (PCT) with the best overall performance and compare these with other PCT with benchmarking methods. DESIGN: Descriptive, cross-sectional study of a set of indictors for the year 2002. SETTING: City of Barcelona (northeastern Spain). PARTICIPANTS: Thirteen seven PCT with more than 2 years' experience, and 771,811 inhabitants in the catchment area. MAIN MEASURES: Indicators were chosen from among those proposed by an advisory group, depending on feasibility of obtaining information. A total of 17 indicators in 4 dimensions were studied: accessibility, clinical effectiveness, case management capacity, and cost-efficiency. Each PCT was scored for each indicator based on the percentile group in the distribution of scores, and for each dimension based on the mean score for all indicators in a given dimension. Overall score for PCT performance was calculated as the weighted sum of the scores for each dimension. As descriptive variables we analyzed time operating under the revised administrative system, patient visits per population served, the population's economic capacity and age of the population. RESULTS. Nine PCT were identified as the benchmark group. Teams in this group had been operating under the revised administrative system for significantly longer than other PCT. In comparison to other PCT, the benchmark group obtained higher scores on all four dimensions, better results on 14 separate indicators, the same results for 1 indicator, and worse results for 2 indicators. CONCLUSIONS. Benchmarking made it possible to identify PCT with the best performance, and to identify areas in need of improvement. This approach is a potentially useful tool for self-evaluation and for stimulating a dynamic for improvement in primary care providers.

Benchmarking↗
PubMed2005

[Consensus on a process of benchmarking in primary care in Barcelona].

OBJECTIVE: To define the strategy, the conceptual framework, the methodology and the indicators that are needed to promote and consolidate the culture of external reference (benchmarking) as a strategy for change in Primary Care teams (PCT). DESIGN: Cross-sectional, descriptive study. SETTING: Primary care services of the Barcelona City Health Region. METHOD: Two stages were distinguished. At the first stage, an adviser group was set up. This was divided into 4 focus groups in which the main lines, the conceptual framework, the sizes, the indicators and the methodology for comparing PCTs were agreed. The second stage, that of prioritization, was conducted by means of a questionnaire to opinion-formers. For each of the indicators proposed, they appraised the degree of agreement, the suitability and relevance of indicators, the capacity of PC to modify results and the practicality of the information for composing the indicators. RESULTS: The involvement of professionals, their approach to improvement, and the transparency and dissemination of the evaluation were identified as strategic elements of benchmarking dynamics. In line with the basic principles of PC and the health system, 6 dimensions for evaluation were set: accessibility, effectiveness, capacity to resolve problems, longitudinality, cost-efficiency, and results. 43 of the 57 indicators prioritized gained the consensus of over 90% of the consultants. CONCLUSIONS: Evaluation as a useful tool for managing PC quality has to generate improvements or changes in PCTs. The involvement of professionals in the design and development of evaluation may help both its acceptance and the implementation of the changes arising from it. The indicators used and the effect of benchmarking policy on the results of PC service delivery require evaluation.

Benchmarking↗
PubMed1990

[Amoxicillin/clavulanic acid and trimethoprim in the treatment of urinary infection in primary care].

The effectiveness of amoxicillin/clavulanic acid (A/Cl) and trimetoprim (TMP) were compared in two different schedules: 10 days treatment and monodose, in 80 patients with, urinary tract infection (UTI) demonstrated by urine culture. The patients over 65 years, the males and those with underlying risk conditions randomly received A/Cl or TMP during 10 days. The rates of cure were 76.9% for A/Cl and 73.9% for TMP. The difference was not significant. Thirty-one patients without those features randomly received a short A/Cl course or a single dose of TMP. The rates of cure were 92.8% for A/Cl and 58.8% for TMP. The difference was statistically significant. It was concluded that, in our patients, complicated lower UTI have a similar response rate to a ten days course of A/Cl or TMP, whereas A/Cl for three days is more effective than a single TMP dose to treat noncomplicated lower UTI.

Amoxicillin↗
PubMed1990

[Hereditary familial neuropathies: genetic counseling and early diagnosis in primary care].

We present 5 cases of sensitive-motor hereditary neuropathies which were detected or controlled in primary care. Four patients had Charcot-Marie-Tooth disease (type I) and the remaining patient is a carrier of Dejerine-Sottas disease (type III). Regardless of the age of presentation of the disease, the evolution has been slow but steady in all cases. Talipes cavus is the most frequent secondary deformity. An electroneuromyographic study and a neural biopsy were the complementary diagnostic tests used. Three of the patients presented family antecedents. We believe that early diagnosis, family study and genetic advice are of great importance in primary care.

Charcot-Marie-Tooth Disease↗
PubMed1990

[Cardiovascular risk factors. An audit of their detection in primary care].

After having found that the prevalences of hypertension, hypercholesterolemia, obesity and smoking were low in our adult population on care, we developed a study to investigate the causes of the problem and to introduce measures for its solution following the methodology of the medical audit. The indexes showed that the performance of preventive cardiovascular activities (PCVA) was low: blood pressure measurement 45%, blood cholesterol determination 23%, height and weight measurement 8% and questioning on smoking habits 40%. After the implementation of corrective measures, indexes of 79%, 76%, 71% and 56%, respectively, have been achieved. In addition, a defective recording of the detected risk factors was found: 87% in the clinical history record, 72% in the age and sex card; after the corrective measures, the rates were 98% and 91% respectively. The present study demonstrates the effectiveness of quality control measures carried out by the professionals responsible for care to improve its quality.

Age Factors↗
PubMed1990

[Monoclonal gammapathy of uncertain significance. A perspective from the primary care setting].

Eight cases of monoclonal gammapathy of uncertain significance are reported. They were detected from routine analysis in patients from the general population who consulted for several diseases to a primary care center. One patient developed multiple myeloma and the rest remained stable. As there is no effective method to identify which patients with monoclonal gammapathy of uncertain significance will undergo a malignant transformation, it is suggested that periodical clinical and laboratory controls are the only effective means for the monitoring of this type of patients.

Aged↗
PubMedDate not supplied

[Functional classification of chronic alcoholic hepatopathy in primary care].

OBJECTIVE: To evaluate the use of Pugh's Classification in assessing patients with diffuse alcoholic Chronic Hepatopathy in the out-patient context. DESIGN: Descriptive-retrospective study. SITE. The Base Health Area of "La Mina" in Barcelona. PATIENTS OR OTHER PARTICIPANTS: 143 patients over the age of 14 diagnosed as suffering diffuse chronic Hepatopathy were identified. 37 of these were excluded because of lack of data. MAIN MEASUREMENTS AND RESULTS: The following data were gathered: those relating to semeiology, anamnesis, quantifying alcoholic intake, where the original diagnosis was made, how rapidly the condition evolved, laboratory and complementary explorations' parameters. Out of the 106 patients studied 71 (67%) were classified in group A; 22 (21%) in B and 13 (12%) in C. No significant differences were found in relation to age or sex. Significant differences concerning the speed of the condition's evolution and the average intake in grammes of alcohol per day were observable. The number of hospital admissions increased as the patient's functional stage became worse and complications increased. CONCLUSIONS: Pugh's test was shown to be useful in the out-patient context for classifying patients suffering chronic diffuse Hepatopathy in line with the severity of their condition.

Adult↗