Con el objetivo de conocer las variaciones en la demanda asistencial en el Centro de Atención Primaria de Ciudad Badia se analizan los registros de actividad durante siete años de funcionamiento.
Los cambios sustanciales introducidos que pueden afectar al sistema de acceso de los usuarios al CAP han sido: creación de la visita concertada médica y de enfermería (VCE) -cita previa-, creación de la tarjeta de medicación crónica (TMC) y limitación de la visita espontánea (VE) con derivación a urgencias si lo precisan. Estos factores se asocian, durante el período estudiado, a una disminución al inicio, una estabilización posterior y finalmente un ligero ascenso de las visitas totales. La actividad concertada pasa del 5,3% en 1983 al 45,2% en 1989 y la VCE del 0,3% en 1986 al 9,5% en 1989, las visitas médicas de urgencias pasan del 3,4% al 8%.
Concluimos que las modificaciones consiguen un aumento de dedicación del personal sanitario a tareas sanitarias (preventivas y terapéuticas), mejor organización asistencial y mayor satisfacción de usuarios y profesionales sanitarios.
The aim of the investigation was to assess variations in the demand for medical care in the primary care centre of Ciudad Badia (Barcelona, Spain). The records of attendance were analysed over a period of seven years.
During this period, some changes were made which affected the way the centre was used by patients, such as the creation of systems which required notice of medical and nursing appointments, the reduction of spontaneous attendance, and the introduction of a card for medication for the chronically sick. These changes were accompanied initially by a decrease, then a stabilisation, and afterwards a slight increase in total number of visits.
All visits (with notice) rose from 5.3% in 1983 to 45.2% in 1989. Similarly, nursing visits (with notice) increased from 4% to 9.5 of total activity. Emergency visits in the same period rose from 3.4% to 8%.
It is concluded that the changes that were introduced raised the level of commitment of the staff to medical work-both preventive and therapeutic, as well as the improvement of the organisation of attendance at the centre and a higher satisfaction of users of the centre and the medical staff.
