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J Ramos Aleixades

Publications and source records attributed to J Ramos Aleixades.

3 recordsLinked to original sources
PubMed2004

[Division of time in the consultation with the primary care doctor].

OBJECTIVE: To determine the mean time per meeting--visit--and per problem attended to in the doctor's office and their distribution according to the care procedure during the visit. DESIGN: Prospective study of the direct encounter in the doctor's office with a third person as timer. SETTING. Three doctors at 2 family medicine clinics (each with a list of about 2500 health cards). PARTICIPANTS: 316 health problems attended to in 289 direct encounters in the doctor's office. Main measurements. Total time according to type of direct encounter in the doctor's office and problem addressed. Determination of the time spent on each stage of the encounter. RESULTS: Mean time per direct encounter in the doctor's office of 9.1 minutes, and mean time per problem attended of 7.4 minutes, with a range from 76 seconds to 25 minutes. 84% were spontaneous visits, 13.5% were scheduled and 2.5% could not be put off/were urgent. Problems were mainly bureaucratic in 17% of cases, organic in 77.4 and psycho-social-family in 5.6%. Mean time devoted to advice and treatment was 2.4 minutes; that devoted to explanation of the problem, 18.3 seconds. The times varied according to the kind of problem, the doctor and the sex and age of the patient. CONCLUSIONS: Distribution of time during the medical visit depends on the kind of problem involved. The doctor and the age and sex of the patient also affect the question. The short time spent on the explanation of the problem suggests that the period for active listening should be extended.

Adult↗
PubMed1998

[Prescriptions of low therapeutic value imposed on primary care].

OBJECTIVES: 1. To quantify the percentage of prescriptions of low therapeutic value, and the associated pharmaceutical expenditure, which the specialist incurs for the general practitioner. 2. To determine which are the therapeutic groups of low therapeutic value most often delegated in this way, and so determine the profile of the specialists who recommend most medication with insufficient benefits. DESIGN: A descriptive, crossover, prospective study based on all the prescriptions of the month of March (21 days) to 4156 patients from the town of Es Castell (5720 inhabitants), Menorca. MATERIAL AND METHODS: The variables to be evaluated were defined and classified in scales. They included prescription, packages, working age/pensioner, origin (General Practitioner, Specialist, Private, Emergency), cost of the prescription, specialties broken down into anatomical-therapeutic groups, whether it was chronic or acute medication, and whether it was of high or low therapeutic value. RESULTS: Of the 3599 packages prescribed, 1993 were generated from outside the PC practice (55.3%). Of the 6069411 pesetas of expenditure in the period studied, 38.5% was due to general practitioners, 59.1% specialists, and 2.3% emergency services. 12.7% (456) of the packages prescribed were of low therapeutic value, of which 52.6% corresponded to the general practitioners' prescriptions, 45.6% to the specialists' and 4.5% to private practice. However, of the 523224 pesetas of expenditure, 62% was for specialists' prescriptions and only 36% for the general practitioners'. On comparing the profiles of prescriptions of low therapeutic value coming from specialists and direct from Primary Care, differences were found. The "cardiovascular" group accounted for 40.9% of specialist prescriptions and only 11.3% of G.P. ones; "central nervous system" (psychiatry, neurology) accounted for 24.5% and 12.1%, respectively. "Respiratory", however, was the opposite: 3.8% specialist and 25% G.P. Similarly the "others" category and 18.8% for specialists against 37.1% for G.P.s. CONCLUSIONS: It can be inferred that there is shared responsibility in the public health system between specialists and G.P.s for prescribing products of low therapeutic value. However, since the medication that specialists prescribe is dearer, they cause more expenditure than the packages of low therapeutic value, which they delegate to G.P.s.

Cross-Over Studies↗