[The economic and labor impact of no staff replacement in primary care. Why and how we should measure it]

La cartera de servicios en atención primaria: significado y comparabilidad

OBJECTIVES

To clarify the significance of the primary care (PC) range of services (RS) output, to determine the factors affecting it and to establish a method to compare the effort or work-load of primary care team (PCT) professionals at HCs.

DESIGN

Transversal, descriptive study of the RS in 2003. Calculation of the method of work load attained by weighted professional.

SETTING

Primary care, IMSALUD Area 1, Madrid, Spain.

MAIN MEASUREMENTS

The RS output correlated significantly and negatively with the family medicine ratios, nursing ratios, and income per head. The RS output at the PCTs ranged between 89.32% and 36.27%; in the method proposed, it range between 9326 and 6167 units/weighted professional.

CONCLUSIONS

The calculation of the current RS output measures the equity of access of the population to the various services of the RS and their coverage, but it does not allow comparison of the work of different PCTs, as it does not take into account the effect of the population on coverage or the size of the work-force that delivers these products. Another calculation is needed, such as the work load attained by weighted professional (work units in PC per professional), that obtains fewer differences in results between professionals.