Conditions associated with overtreatment according to annual number of consultations in a first-level health care institution in Medellín, Colombia, 2018

Abstract

Objective. Describe and compare the behavior of overtreatment based on three multivariate models, and identify the demographic, socioeconomic, clinical, and administrative conditions that could be associated with its prevalence in an institution providing health services. Materials and methodology. Cross-sectional design on the census of medical care recorded during a year. Demographic, socioeconomic, clinical, and administrative variables were studied. In the absence of agreement on the concept of overtreatment three different scenarios were studied for three, eight and ten or more consultations during the study period. The prevalence of the variables was measured and bi- and multivariate associations were established based on the Odds Ratio (OR). Results. A greater number of consultations were statistically associated with being a woman, over 60 years of age, having a partner, attending scheduled preventive consultations, consulting in the first half of the year, having a diagnosis of diseases of the musculoskeletal system or connective tissue, and having received four or more days of temporary disability in the year. Some effect sizes were small, and their practical utility may be limited. Conclusions. Understanding overtreatment requires considering individual conditions, the health system, the socio-cultural context, and current legislation. It is recommended that quality audits and qualitative studies be carried out that explore the patients' perceptions about their health status and their use of the services.