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=Paraules Mesh= | |||
==Cerques fetes== | |||
*"Primary Health Care"[Mesh] AND "Health Services Misuse/statistics and numerical data"[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND "Models, Theoretical"[Mesh] AND "Cross-Sectional Studies"[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND Attitude to Health [mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND "Models, Theoretical"[Mesh] AND"Cohort Studies"[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND "Religion and Psychology"[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND "Age Factors"[Mesh] AND "Models, Theoretical"[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND "Age Factors"[Mesh] AND "Health Services Research"[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND Capitation Fee[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND Chronic Disease/epidemiology [Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND Chronic Disease/psychology | |||
*"Primary Health Care/utilization"[Mesh] AND Educational Status | |||
*"Primary Health Care/utilization"[Mesh] AND Health Status[mesh] AND "Health Services Research"[Mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND Morbidity[Mesh] AND Health Services Research[mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND "Patient Acceptance of Health Care/statistics and numerical data"[Mesh] AND Health Services Research[mesh] | |||
*"Primary Health Care/utilization"[Mesh] AND "Appointments and Schedules"[Mesh] AND "Models, Theoretical"[Mesh] | |||
==Freqüentació== | |||
Ambulatory Care/utilization* | |||
Appointments and Schedules | |||
Continuity of Patient Care/statistics & numerical data* | |||
Health Services/utilization* | |||
Health Services Misuse/statistics & numerical data | |||
Health Services Needs and Demand*/statistics & numerical data | |||
Office Visits/statistics & numerical data* | |||
Office Visits/utilization* | |||
Primary Health Care*/statistics & numerical data | |||
Primary Health Care/utilization* | |||
utilization | |||
Utilization Review | |||
Utilization Review/statistics & numerical data | |||
Workload* | |||
==Factors associats== | |||
Affective Symptoms/epidemiology | |||
'''Age Factors''' | |||
Attitude to Health | |||
Attitude of Health Personnel* | |||
'''Capitation Fee''' | |||
Catholicism | |||
'''Chronic Disease''' | |||
'''Chronic Disease/epidemiology''' | |||
'''Chronic Disease/psychology''' | |||
Depression/epidemiology* | |||
'''Educational Status''' | |||
Family Characteristics* | |||
Family Characteristics* | |||
Family Practice* | |||
Family Practice/organization & administration | |||
Family Practice/statistics & numerical data* | |||
Family Relations | |||
Health Behavior | |||
Health Care Rationing* | |||
Health Services Accessibility* | |||
Health Services for the Aged/utilization* | |||
Health Services Needs and Demand | |||
'''Health Status''' | |||
Jews/psychology | |||
Jews/statistics & numerical data | |||
Marital Status | |||
Mental Disorders/diagnosis | |||
Mental Disorders/epidemiology | |||
Mental Disorders/psychology | |||
Models, Organizational* | |||
'''Morbidity''' | |||
Motivation | |||
Neurotic Disorders/epidemiology* | |||
Outpatients/classification* | |||
Outpatients/psychology | |||
Patient Acceptance of Health Care | |||
Patient Acceptance of Health Care/ethnology | |||
Patient Acceptance of Health Care/psychology* | |||
Patient Acceptance of Health Care/statistics & numerical data* | |||
Patients/psychology* | |||
Patient Satisfaction | |||
Personality Assessment | |||
Personality Inventory | |||
Poverty Areas* | |||
Physician-Patient Relations* | |||
Physicians, Family/utilization* | |||
Physician's Practice Patterns/statistics & numerical data* | |||
Practice Management, Medical | |||
Practice Management, Medical/organization & administration* | |||
Protestantism | |||
Psychology, Social | |||
Religion and Psychology* | |||
Risk Factors | |||
Self Assessment (Psychology) | |||
Severity of Illness Index | |||
Sex Factors | |||
Sick Role* | |||
Social Class | |||
Social Support | |||
Socioeconomic Factors | |||
Urban Health | |||
==Mètodes== | |||
Case-Control Studies | |||
Chi-Square Distribution | |||
Cross-Sectional Studies | |||
Cohort Studies | |||
Follow-Up Studies | |||
Confidence Intervals | |||
Health Care Surveys | |||
Health Services Research | |||
Health Surveys | |||
Interviews | |||
Likelihood Functions | |||
Logistic Models | |||
Models, Theoretical | |||
Odds Ratio | |||
Prospective Studies | |||
Qualitative Research | |||
Questionnaires | |||
Regression Analysis | |||
Retrospective Studies | |||
=Estat actual del tema= | |||
==Definició d'hiperfreqüentador== | |||
*Majors de 14 anys i amb més de 8 visites/metge/any. | |||
*Número de visites superior a 2 desviacions estàndard de la mitja de freqüentació. | |||
==Perfil de l'hiperfreqüentador== | |||
*Són una part important de la demanda, son un 12-21% de la població que usa el 46-50% de les consultes. | |||
*Edat mitja. | |||
*Predomini femení. | |||
*Múltiples problemes de salut tant físics com mentals. | |||
*Valorar si cal recollir si el pacient és pensionista o no. En l'article <cite>guerra_ap</cite>, ho tenen en compte, però no sé en què es basen. | |||
==Factors que condicionen la hiperfreqüentació== | |||
*Característiques de la població. | |||
**L'edat cada cop més gran de la població. | |||
**Estat de salut de la població. | |||
**Segons la importància que se li dóna a la malaltia <cite>guerra_ap</cite>. Sobretot les cardiovasculars, osteoarticulars, però també les cròniques i mentals. | |||
**El nivell socioeconòmic podria influir en la HF dels serveis públics, ja que se sposa que els rics van a la privada <cite>guerra_ap</cite>. | |||
**Falta de suport social o familiar augmenten la HF <cite>guerra_ap</cite>. | |||
*Factors del professional. | |||
**No influeix la satisfacció amb el seu metge o infermera. | |||
*Factors de la organització. | |||
**Un augment d'accessibilitat augmenta la freqüentació segons els propis pacients <cite>guerra_ap</cite>. | |||
**La satisfacció amb el centre podria augmentar la HF <cite>guerra_ap</cite>. | |||
=Metodologia utilitzada= | |||
*Per als factors que determinen l'hiperfreqüentació: | |||
**Metodologia qualitativa amb grups focals <cite>guerra_ap</cite>. | |||
=Bibliografia= | |||
==Llegits== | |||
*Factors explicatius de la HF amb metodologia qualitativa <cite>guerra_ap</cite>. | |||
==Pendents de llegir== | |||
*Definició HF <cite>lourenzo_econh, neal_brgen, wilson_brgen, howe_brgen, neal_brgen3, anderson_scan, knishkowy_jfp</cite>. | |||
*Descripció de la freqüentació <cite>crampton_nzeland, busato_famprac, lou_ap, arenas_ap, capitation, sidorov, carlson_bmc, papa_bmc, suominen_bmc, halloran_austr, flemming, sihvonen_scand, ovaskainen_hp</cite>. | |||
*Variabilitat <cite>guerra_ap2, bolanos_fp</cite>. | |||
*Demanda induïda <cite>bellon_ap</cite>. | |||
*Perfil de l'HF <cite>byrne_annals, kapur_brgen, bergh_scand, vedsted_publich, bellon_psychol, dowrick_brgen, ortega_ap, frostholm_psychosom, aguirre_ap, segovia_ap, orueta_ap, probst_fammed, rubio_ap, carlsson_scand</cite>. | |||
*Factors explicatius de l'HF <cite>eggen_scand, kransic_dmb, foster_fp, vedsted_social, burgos_ap, smucker_jfm, kapur_psychol, mancera_ap, meer_psychosom, baez_ap, bago_hecon, crampton_nzeland2, bellon_gc, portella_gc, otero_ap, dovey_nzeland, conrad_jama, jyv, karlsson, parslow_soc, scott_hsrm, gross_wh, sutton_soc, mendoza_saudi, keene_jph</cite>, el model explicatiu d'Andersen <cite>andersen_beh</cite>, socio-economics <cite>pescosolido_sociol, martinez_ap, gomez_famprac</cite>, factors psicològics <cite>bebbington_psychol, thode_bgg, virtanen_bmc, have_psyepi, cort_ap pmid, korff_agp, lopez_ap</cite>, sistemes d'organització dels serveis sanitaris <cite>sominen_eurph</cite>, religió <cite>reindl_social</cite>. | |||
*Metodologia <cite>vedsted_phealth</cite>: | |||
**Estudis qualitatius <cite>neal_brgen2, hodgson_annals</cite>. | |||
**Multivariant <cite>bellon_ap2</cite>. | |||
==Pendents de buscar== | |||
*Referència 15, 22 de <cite>guerra_ap</cite>. | |||
==Referències== | |||
<biblio> | |||
#guerra_ap pmid=17669318 | |||
#byrne_annals pmid=12605196 | |||
#burgos_ap pmid=12812687 | |||
#andersen_beh pmid=7738325 | |||
#pescosolido_sociol Pescosolido B. ''[http://links.jstor.org/sici?sici=0002-9602%28199201%2997%3A4%3C1096%3ABRCTSD%3E2.0.CO%3B2-L Beyond Rational Choice: The Social Dynamics of How People Seek Help]''. The American Journal of Sociology, Vol. 97, No. 4, New Directions in the Sociology of Medicine. (Jan., 1992), pp. 1096-1138. | |||
#kapur_brgen pmid=11593846 | |||
#bergh_scand pmid=14531510 | |||
#vedsted_publich pmid=11939384 | |||
#bellon_psychol pmid=10616940 | |||
#dowrick_brgen pmid=10897531 | |||
#neal_brgen pmid=9604412 | |||
#ortega_ap pmid=14967124 | |||
#smucker_jfm pmid=11674886 | |||
#kapur_psychol pmid=15099425 | |||
#mancera_ap pmid=11412559 | |||
#neal_brgen2 pmid=11050788 | |||
#hodgson_annals pmid=16046564 | |||
#have_psyepi pmid=16003591 | |||
#sominen_eurph pmid=15542872 | |||
#meer_psychosom pmid=9623879 | |||
#frostholm_psychosom pmid=16314606 | |||
#reindl_social pmid=14572925 | |||
#lourenzo_econh pmid=16127679 | |||
#aguirre_ap pmid=15225536 | |||
#wilson_brgen pmid=12830576 | |||
#howe_brgen pmid=12120728 | |||
#neal_brgen3 pmid=11224969 | |||
#baez_ap pmid=10413982 | |||
#segovia_ap pmid=9887577 | |||
#anderson_scan pmid=8919367 | |||
#orueta_ap pmid=8329552 | |||
#sihvonen_scand pmid=2284523 | |||
#bago_hecon pmid=16127676 | |||
#thode_bgg pmid=15768302 | |||
#virtanen_bmc pmid=17014702 | |||
#vedsted_social pmid=15177837 | |||
#probst_fammed pmid=12269538 | |||
#bebbington_psychol pmid=11097076 | |||
#crampton_nzeland pmid=17589550 | |||
#busato_famprac pmid=16115833 | |||
#crampton_nzeland2 pmid=11194763 | |||
#rubio_ap pmid=9931557 | |||
#bellon_gc pmid=8666513 | |||
#cort_ap pmid=8518351 | |||
#lopez_ap pmid=1420775 | |||
#portella_gc pmid=1295842 | |||
#otero_ap pmid=1504224 | |||
#dovey_nzeland pmid=1625824 | |||
#lou_ap pmid=2129725 | |||
#arenas_ap pmid=2129724 | |||
#martinez_ap pmid=2104132 | |||
#bellon_ap pmid=17020715 | |||
#bellon_ap2 pmid=1807435 | |||
#capitation pmid=16381327 | |||
#sidorov pmid=12068963 | |||
#guerra_ap2 pmid=10547919 | |||
#conrad_jama pmid=9516000 | |||
#carlson_bmc pmid=16483353 | |||
#carlsson_scand pmid=15370795 | |||
#gomez_famprac pmid=8872097 | |||
#korff_agp pmid=1550468 | |||
#jyv pmid=9800226 | |||
#karlsson pmid=7895972 | |||
#papa_bmc pmid=17081303 | |||
#suominen_bmc pmid=16952306 | |||
#halloran_austr pmid=16489377 | |||
#parslow_soc pmid=15351477 | |||
#scott_hsrm pmid=12626026 | |||
#gross_wh pmid=11708687 | |||
#sutton_soc pmid=10468392 | |||
#mendoza_saudi pmid=14666207 | |||
#flemming pmid=10165630 | |||
#vedsted_phealth pmid=15694959 | |||
#foster_fp pmid=16675502 | |||
#keene_jph pmid=15637107 | |||
#ovaskainen_hp pmid=14637008 | |||
#bolanos_fp pmid=12028800 | |||
#kransic_dmb pmid=9408740 | |||
#eggen_scand pmid=8484078 | |||
#knishkowy_jfp pmid=1985136 | |||
</biblio> | |||