Morbilidad y uso de recursos de las personas incluidas en el programa de atención domiciliaria de la atención primaria

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria Pub Date : 2025-06-21 DOI:10.1016/j.aprim.2025.103276

Manuel Medina Peralta , Marta Torres , David Guananga , Violeta Poltorak , Sergi Sánchez-Coll , Mireia Espallargues

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引用次数: 0

Abstract

Objective

To describe health status and health care services of the people included in home care program (HC) through secondary use of data from the public system.

Design

Observational population-based study.

Location

Primary health care in Catalonia (2022).

Participants

All people over 65 years of age included in HC matched 1:1 with people not attended in HC by age, sex, socioeconomic level and primary care team (45,578 persons per group, 70.5% women and mean age 86.8 years).

Interventions

People receiving HC.

Main measurements

Morbidity, healthcare use and events (hospital admissions, mortality).

Results

53.6% of people in HC had a diagnosis of complex chronic patient and 5.7% of advanced chronic disease, compared to 1.1% and 0.05% in the non-HC population. There were more people in HC with heart failure, dementia, stroke, auricular fibrillation and COPD, with higher drug use and pharmaceutical expenditure (€1,446 vs. €732, ratio 1.98, 95%CI 1.95-2.00). Mortality was 20% in HC and 6% in the non-HC population (ratio 3.3, 95%CI 3.17-3.44). A stratified analysis by age showed a higher complexity, morbidity and events in people between 65 and 80 years of age with respect to those over 80 years of age in HC.

Conclusions

The results, which show increased morbidity and complexity in HC, especially in people under 80 years of age, may be useful to better identify care needs of these people and program planning.

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初级保健家庭保健方案所包括的人的发病率和资源利用情况

目的通过对公共系统数据的二次利用，了解参保人员的健康状况和卫生保健服务情况。设计：观察性人群研究。加泰罗尼亚的初级卫生保健（2022年）。参与者按年龄、性别、社会经济水平和初级保健团队划分，所有65岁以上的HC患者与未参加HC的患者1:1匹配（每组45,578人，70.5%为女性，平均年龄86.8岁）。干预措施接受HC治疗的人。主要测量指标：发病率、医疗保健使用和事件（入院、死亡）。结果HC人群中53.6%诊断为复杂慢性患者，5.7%诊断为晚期慢性疾病，而非HC人群中这一比例分别为1.1%和0.05%。HC患者中有更多的人患有心力衰竭、痴呆、中风、耳颤和慢性阻塞性肺病，药物使用和药物支出也更高（1446欧元对732欧元，比值1.98,95%CI 1.95-2.00）。HC人群死亡率为20%，非HC人群死亡率为6%（比值3.3,95%CI 3.17-3.44）。按年龄分层分析显示，65 - 80岁人群的复杂性、发病率和事件高于80岁以上人群。结论HC的发病率和复杂性增加，特别是80岁以下人群，这一结果可能有助于更好地识别这些人群的护理需求和方案规划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atencion Primaria 医学-医学：内科

CiteScore

2.90

自引率

8.00%

发文量

156

审稿时长

33 days

期刊介绍： Atención Primaria es una revista que publica trabajos de investigación relativos al ámbito de la atención primaria de salud. Desde el punto de vista conceptual, Atención Primaria asume el nuevo modelo de atención primaria de salud, orientado no sólo a la curación de la enfermedad, sino también a su prevención y a la promoción de la salud, tanto en el plano individual como en el de la familia y la comunidad. En estos nuevos aspectos que definen el modelo de atención primaria de salud es en los que se centran los trabajos de investigación que publica Atención Primaria, la primera revista de originales española creada para recoger y difundir la producción científica realizada desde los centros de atención primaria de salud sobre cuestiones como protocolización de la asistencia, programas de prevención, seguimiento y control de pacientes crónicos, organización y gestión de la asistencia primaria, entre otros.