P2-5 Variability in the control of chronic patients in primary care according to the electronic clinical record

• Published in: Journal of epidemiology and community health (1979) Vol. 65; no. Suppl 1; p. A221
• Main Authors: Aizpuru, F, Vergara, I, de Arriba, J P, Latorre, A, Ibañez, B, Latorre, K, Apiñaniz, A, Samper, R, Bilbao, J L
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.2011; BMJ Publishing Group LTD
• Subjects: Alcohol; Asthma; Compliance; dementia disorders; depression; diabetes mellitus; hypertension; obesity; Respiratory diseases; Spain
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech.2011.142976h.42

IntroductionThis study aims to describe the variability in Primary Care to comply with the good practice requirements (GPR) for the management of the following chronic conditions: Hypertension, hypercholesterolaemia, diabetes, alcohol abuse, COPD, depression, dementia, anxiety, asthma and obesity.MethodsThe electronic clinical records of all general practitioners (1685; 2 147 754 professionals) of Osakidetza/Basque Health Service were examined. The rate of compliance of each of the GPR considered by the Health Plan of Basque Autonomous Community of Spain, standardised by age and sex, was calculated, as well as the variability statistics: extremal quotient (EQ5–95), coefficient of variation (CV5–95) and systematic component of variation (SCV5–95).ResultsThe electronic records show that more than half of the patients are correctly controlled in nine out of the 44 GPR studied. On the contrary, in 16 GPR the compliance rate is lower than 25% of the diagnosed patients. The smallest variability inter-centres is observed in the management of hypertension, hypercholesterolaemia, obesity and diabetes, all with SCV5–95 <0.10. Disparity is moderate in COPD and alcohol abuse (0.10<SCV5–95<0.20), high in depression, anxiety, dementia and asthma in adults (0.20<SCV5–95<0.50) and very high in asthma in children (SCV5–95≥0.50).ConclusionControl of patients diagnosed with chronic processes, especially those with a shorter tradition in Primary Care is insufficient.