Modelos explicativos y predictivos de la carga asistencial médica: aplicación para el cálculo del cupo máximo en medicina de familia que permita un mínimo de diez inutos por consulta
Estimar el cupo máximo en medicina familiar que permita consultas mínimas de 10 min Transversal Tres centros de salud Un total de 45.826 habitantes A partir de las citas de tres centros estimamos el tiempo anual empleado por paciente y lo ajustamos asignando un tiempo mínimo de 10 min por consulta....
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Published in | Atención primaria Vol. 32; no. 1; pp. 23 - 29 |
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Main Authors | , , , |
Format | Journal Article |
Language | Spanish English |
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Elsevier Espana
2003
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Abstract | Estimar el cupo máximo en medicina familiar que permita consultas mínimas de 10 min
Transversal
Tres centros de salud
Un total de 45.826 habitantes
A partir de las citas de tres centros estimamos el tiempo anual empleado por paciente y lo ajustamos asignando un tiempo mínimo de 10 min por consulta. Establecemos un modelo de regresión cúbica predictor de la carga de trabajo asistencial media por edad en medicina general y estimamos el cupo máximo si se dedica un 70% de la jornada laboral a la asistencia. Exponemos los resultados para dos centros con mayor implicación de enfermería en la atención de los pacientes, y otro en que ésta es menor. Presentamos los coeficientes R2. Estimamos los cupos máximos para los centros de salud de Navarra y los mostramos en cinco grupos elaborados a partir del porcentaje de población de 65 años o más
La edad explica el 86,1% de la variabilidad en la carga asistencial media en cada edad (un 84% en ninos y un 93,5% en adultos). Segun el porcentaje promedio de sujetos > 65 anos de edad los cupos maximos promedios para centros con mayor o menor implicacion de enfermeria son los siguientes: 7% (2.025 y 1.989); 14% (1.834 y 1.715); 21,2% (1.691 y 1.558); 27% (1.648 y 1.460); 34% (1.560 y 1.340)
La edad explica en gran medida la variabilidad de la carga asistencial y permite estimar el cupo maximo de pacientes que asegure un tiempo minimo por consulta
To calculate the maximum family medicine list that gives at least ten minutes per consultation
Transversal
Three health centres
45 826 inhabitants
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
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)
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 |
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AbstractList | Estimar el cupo máximo en medicina familiar que permita consultas mínimas de 10 min
Transversal
Tres centros de salud
Un total de 45.826 habitantes
A partir de las citas de tres centros estimamos el tiempo anual empleado por paciente y lo ajustamos asignando un tiempo mínimo de 10 min por consulta. Establecemos un modelo de regresión cúbica predictor de la carga de trabajo asistencial media por edad en medicina general y estimamos el cupo máximo si se dedica un 70% de la jornada laboral a la asistencia. Exponemos los resultados para dos centros con mayor implicación de enfermería en la atención de los pacientes, y otro en que ésta es menor. Presentamos los coeficientes R2. Estimamos los cupos máximos para los centros de salud de Navarra y los mostramos en cinco grupos elaborados a partir del porcentaje de población de 65 años o más
La edad explica el 86,1% de la variabilidad en la carga asistencial media en cada edad (un 84% en ninos y un 93,5% en adultos). Segun el porcentaje promedio de sujetos > 65 anos de edad los cupos maximos promedios para centros con mayor o menor implicacion de enfermeria son los siguientes: 7% (2.025 y 1.989); 14% (1.834 y 1.715); 21,2% (1.691 y 1.558); 27% (1.648 y 1.460); 34% (1.560 y 1.340)
La edad explica en gran medida la variabilidad de la carga asistencial y permite estimar el cupo maximo de pacientes que asegure un tiempo minimo por consulta
To calculate the maximum family medicine list that gives at least ten minutes per consultation
Transversal
Three health centres
45 826 inhabitants
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
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)
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 |
Author | Guillén Grima, F. Mallor Giménez, F. Brugos Larumbe, A. Fernández Martínezde Alegría, C. |
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Cites_doi | 10.1136/bmj.323.7316.784 10.1097/00005650-199105000-00006 10.1097/00005650-199903000-00004 10.1016/S0212-6567(01)78887-7 10.1016/S0212-6567(01)79379-1 10.1136/bmj.324.7342.880 10.1177/107755878203900101 10.1136/bmj.288.6435.1963 10.1097/00005650-199801000-00004 10.1136/bmj.321.7276.1541 10.1016/S0212-6567(01)79370-5 10.1136/bmj.319.7212.738 |
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DocumentTitleAlternate | 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 |
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Keywords | Medicina de familia Family medicine Calculation Maximum lists Cupos máximos Estimación |
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Diez minutos por paciente en agendas flexibles publication-title: Aten Primaria doi: 10.1016/S0212-6567(01)79379-1 contributor: fullname: Borrel – volume: 324 start-page: 880 year: 2002 ident: 10.1016/S0212-6567(03)78853-2_bib0050 article-title: Evolving general practice consultation in Britain: issues of length and context publication-title: Bmj doi: 10.1136/bmj.324.7342.880 contributor: fullname: Freeman – volume: 93 start-page: 1 year: 1982 ident: 10.1016/S0212-6567(03)78853-2_bib0065 article-title: Hospital case mix: its definition, measurement and use. Part I. The conceptual framework publication-title: Med Care doi: 10.1177/107755878203900101 contributor: fullname: Hornbrook – volume: 288 start-page: 1963 year: 1984 ident: 10.1016/S0212-6567(03)78853-2_bib0115 article-title: Equity and consultation rates in general practice publication-title: Bmj doi: 10.1136/bmj.288.6435.1963 contributor: fullname: Blaxter – volume: 36 start-page: 8 year: 1998 ident: 10.1016/S0212-6567(03)78853-2_bib0130 article-title: Comorbidity measures for use with administrative data publication-title: Med Care doi: 10.1097/00005650-199801000-00004 contributor: fullname: Elixhauser – volume: 61 start-page: 44 year: 2001 ident: 10.1016/S0212-6567(03)78853-2_bib0040 article-title: El »tiempo dedicado al paciente« importa publication-title: Jano contributor: fullname: Sánchez-Vivar – year: 2000 ident: 10.1016/S0212-6567(03)78853-2_bib0060 contributor: fullname: Smith – volume: 321 start-page: 1541 year: 2000 ident: 10.1016/S0212-6567(03)78853-2_bib0005 article-title: Hamster health care time to stop running faster and redesing health care publication-title: Bmj doi: 10.1136/bmj.321.7276.1541 contributor: fullname: Morrison – volume: 27 start-page: 297 year: 2001 ident: 10.1016/S0212-6567(03)78853-2_bib0035 publication-title: Diez minutos, ¡qué menos! Aten Primaria doi: 10.1016/S0212-6567(01)79370-5 contributor: fullname: Casajuana – year: 1982 ident: 10.1016/S0212-6567(03)78853-2_bib0110 contributor: fullname: Towsend – volume: 26 start-page: 53 year: 1991 ident: 10.1016/S0212-6567(03)78853-2_bib0080 article-title: Ambulatory care groups: a categorization of diagnoses for research and management publication-title: Health Services Reseach contributor: fullname: Starfield – volume: 11 start-page: 5 year: 1988 ident: 10.1016/S0212-6567(03)78853-2_bib0085 article-title: Ambulatory case mix classification systems: an overview publication-title: J Ambulattory Care Mgmt contributor: fullname: Smithline – volume: 319 start-page: 738 year: 1999 ident: 10.1016/S0212-6567(03)78853-2_bib0020 article-title: Quality at general practice consultations: cross sectional survey publication-title: Bmj doi: 10.1136/bmj.319.7212.738 contributor: fullname: Howie – volume: 22 start-page: 627 year: 1998 ident: 10.1016/S0212-6567(03)78853-2_bib0120 article-title: Hiperfrecuentación en atención primaria: estudio de los factores psicosociales publication-title: Aten Primaria contributor: fullname: Rubio |
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Snippet | Estimar el cupo máximo en medicina familiar que permita consultas mínimas de 10 min
Transversal
Tres centros de salud
Un total de 45.826 habitantes
A partir de... |
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StartPage | 23 |
SubjectTerms | Calculation Cupos máximos Estimación Family medicine Maximum lists Medicina de familia Originales |
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Title | Modelos explicativos y predictivos de la carga asistencial médica: aplicación para el cálculo del cupo máximo en medicina de familia que permita un mínimo de diez inutos por consulta |
URI | https://dx.doi.org/10.1016/S0212-6567(03)78853-2 https://pubmed.ncbi.nlm.nih.gov/PMC7668788 |
Volume | 32 |
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