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"titulo" => "Patterns of health services use and costs in patients with mental disorders in primary care"
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"resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar el patrón de uso de servicios y costes en pacientes que demandan atención por problemas mentales (PM) en asistencia primaria en situación de práctica clínica habitual.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo. Se incluyeron pacientes mayores de 15 años, con al menos una demanda de atención por PM, atendidos por 5 equipos de atención primaria durante el año 2004. Se formó un grupo comparativo con el resto de pacientes sin PM. Las variables fueron: edad, sexo, casuística/ comorbilidad, utilización de recursos sanitarios y costes ambulatorios correspondientes (medicamentos, procedimientos diagnósticos y visitas). Se empleó el análisis de regresión logística múltiple y modelos de ANCOVA.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 64.072 pacientes, de los cuales 11.128 presentaron algún PM (17,4%; intervalo de confianza [IC] del 95%, 16,7-18,1). Los pacientes que demandaron atención por PM presentaron un mayor número de problemas de salud (6,7 frente a 4,7; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,0001) y de utilización de recursos sanitarios, particularmente visitas médicas/paciente/año (10,7 frente a 7,2; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,0001). El coste medio anual en pacientes con PM fue significativamente superior (851,5 frente a 519,2 euros; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,0001) y se mantuvo después de corregir por edad, sexo y comorbilidades, con un coste diferencial de 72,7 euros (IC del 95%, 59,2-85,9). Todos los componentes del coste por paciente fueron mayores en el grupo de pacientes con PM.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los pacientes que han demandado atención por algún PM presentan un elevado número de comorbilidades y un mayor coste anual por paciente en el ámbito de la atención primaria.</p>"
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"titulo" => "Abstract"
"resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the pattern of services use and costs of patients requiring care for mental disorders (MD) in primary care in the context of routine clinical practice.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective study of patients older than 15 consulting primary care at least once for MD, attended by 5 primary care teams in 2004. A comparative group was formed with the remaining outpatients without MD. The main measurements were age, gender, case-mix/comorbidity and health resource utilization and corresponding outpatient costs (drugs, diagnostic tests and visits). Multiple logistic regression analysis and ANCOVA models were applied.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 64,072 patients were assessed, of which 11,128 had some type of MD (17.4%; 95% CI, 16.7-18.1). Patients consulting for MD had a greater number of health problems (6.7 vs. 4.7; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001) and higher resource consumption, mainly all-type medical visits/patient/year (10.7 vs. 7.2; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001). The mean annual cost per patient was higher for patients with MD (851.5 vs. 519.2 euros; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001), and this difference remained significant after adjusting by age, sex and comorbidities, with a differential cost of euros 72.7 (95% CI, 59.2-85.9). All components of outpatient management costs were significantly higher in the MD group.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Outpatients seeking care for some type of MD had a high number of comorbidities and showed greater annual cost per patient in the primary care setting.</p>"
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