Obcia̧żenie praca̧ w podstawowej opiece zdrowotnej - Analiza zgłaszalności w zależności od wieku i płci pacjenta

Introduction: Reforms of the health care organization, the introduction of the concept of family medicine and the introduction of electronic data collection systems revealed many interesting medical phenomena and practically verified theoretical foundations of the system's operation. They exposed health needs of specific groups of patients and medical consequences of certain administrative decisions. The aim of the paper was to assess the attendance rate (defined as a number of services provided by the clinic per patient on the active list) in the basic health care institutions in relation to the patient's age and sex, to verify the correctness of age brackets imposed by the National Health Fund and resultant per capita rates, as well as to compare attendance rates at various practices with diversified patient age structures. Material and method: The retrospective analysis included data from 2005 covering 134,298 patient records originating from three Olsztyn-based multi-practitioner family doctor practices extending care to 24.405 people, using the same computer system for their work. Results: The study demonstrated that the attendance rate was dependent on the age and sex and was not correlated with the financing rules imposed by the National Health Fund, in particular in the group of small children. Moreover, the study revealed a higher attendance rate for females over the age of 16 than for males of the same age. Conclusions: A very high number of children between the age of 0 and 3 reported sick, corresponding to the number observed among patients between the age of 70 and 80, causes a considerable work burden for pediatricians from the outpatient health care sector and is not reflected in the system of the medical services financing. The current structure of the health care system discriminates financially against those practitioners. The phenomenon of a higher attendance rate in the case of adult females than in the case of males calls for a separate study.