[Analysis of the claims in a specialist primary care center].

  • Nebot Adell C
  • Juvanet Ribot N
  • Orfila Pernas F
  • et al.
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OBJECTIVE To analyze the written claims attended at a specialists unit of a Primary Health Care Center in Nou Barris, Barcelona. DESIGN Evaluative observational study. SETTING Health Care District of Nou Barris, with a population of 170,849. Period of study covers claims attended between 1-6-1996 to 31-12-1998. PARTICIPANTS 220 claims registered at a specialist unit of a primary health care center. MEASUREMENTS Claimer's age and gender, heath care net of origin, claim's motive, claimed person or service and health care activity. Statistical analyses performed included descriptive techniques and Khi-square (chi 2) tests (alpha = 0.05). RESULTS Cumulative incidence of claims was 4.03 per 10,000 person-year in 1996, 4.70 in 1997 and 5.88 in 1998 (p = 0.0128). 220 claims were analyzed, 53.1% of them came from women. Mean age was 51.12 +/- 15.8 years. 60% of claims came from people using the traditional health care net, and 40% from reformed health care net. Mean time of response was 12.3 +/- 12.7 days. Ophthalmology was the most claimed service (18.64%), followed by "the system" (13.64%), and "the center" (13.64%). 64% of claims pointed to specialists, and don't adjusted with their health care activity (p = 0.0001). Relative risk of being claimed at the specialists unit was 2.91, compared to the rest of the primary health care centers of Nou Barris in 1998. CONCLUSIONS Health care user's claims become useful to detect some difficult aspects. However, improvements in the methodology of their evaluation are needed.




Nebot Adell, C., Juvanet Ribot, N., Orfila Pernas, F., Abós Herràndiz, R., & Canela Soler, J. (2000). [Analysis of the claims in a specialist primary care center]. Atencion Primaria, 26(2), 107–10. https://doi.org/10.1016/S0212-6567(00)78620-3

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