Utilización de recursos de atención primaria por parte de inmigrantes y autóctonos que han contactado con los servicios asistenciales de la ciudad de Lleida

ObjetivoEvaluar y comparar la utilización de recursos en los distintos servicios de atención primaria (AP) entre inmigrantes y autóctonos.DiseñoEstudio observacional transversal en población visitada en AP.EmplazamientoPersonas atendidas por 15 médicos de AP en 5 áreas básicas de salud (ABS) de la ciudad de Lleida de marzo a agosto de 2005.ParticipantesSe incluyó a todos los inmigrantes atendidos durante el período de estudio (1.599 pacientes de origen inmigrante). Se realizó un muestreo aleatorio de 300 pacientes en cada una de las 15 consultas participantes (4.156 pacientes de origen autóctono). Se consideró población autóctona aquella cuyo país de origen es España y población inmigrante aquella que proviene de los países de renta baja y media, independientemente del tiempo de asistencia al ABS.Mediciones principalesEdad, sexo, tipo de visitas realizadas y las derivaciones efectuadas. Se utilizaron modelos de regresión multinomial para estimar el riesgo relativo (RR) de haber realizado las visitas.ResultadosLos inmigrantes tienen una probabilidad superior a los autóctonos de realizar más de 3 visitas, frente a 1 o 2 visitas (RR = 1,23; intervalo de confianza [IC] del 95%, 1,04-1,91%). La estimación del RR de haber realizado visitas es superior en los inmigrantes para todas las categorías, excepto en enfermería (RR = 0,59; IC del 95%, 0,5-0,71%).ConclusionesLos inmigrantes que contactan con AP lo hacen con mayor frecuencia en las consultas de medicina de familia y de ginecología, y además se realizan más pruebas complementarias. Sin embargo, la frecuentación del colectivo inmigrante a las consultas de enfermería parece ser inferior.ObjectiveTo evaluate and compare the use of the different primary care (PC) services between immigrants and the indigenous population.DesignCross-sectional observation study of a population seen in (PC).SettingPatients seen by 15 PC doctors, in 5 basic health areas (BHA) in the city of Lleida, Spain, from March to August 2005.ParticipantsAll immigrants (1599 patients of immigrant origin) who seen during the study period were included. A random sample of 300 patients was taken from each of the 15 participating clinics (4156 autochthonous patients). The autochthonous was considered as those whose country of origin is Spain and the immigrant population those who come from low and medium income countries, regardless of the time of residence in the BHA.Primary measurementsAge, sex, type of visit made, and referrals made. Multinomial regression models were used to calculate the relative risk (RR) of having made visits.ResultsImmigrants have a higher probability to make 3 visits than the indigenous population, who would make 1 or 2 visits (RR, 1.23; 95% confidence interval, 1.04-1.91). The estimation of the RR of having made visits is higher in the immigrants for all categories, except nursing.ConclusionsImmigrants who come into contact with PC, make more frequent visits to the family doctor and gynaecology, and also have more complementary tests done. However, the frequency of use of the immigrant group for nursing visits seems to be less

Estudio observacional del gasto farmacéutico en población inmigrante y autóctona de la región sanitaria de Lleida (Cataluña)

Objetivos Analizar si hay diferencias en el gasto farmacéutico entre inmigrantes y autóctonos en la población general y si el ámbito de residencia (urbano/rural) está asociado al gasto en farmacia. Diseño Estudio observacional transversal. Emplazamiento Región Sanitaria Lleida. Participantes Se estudiaron 22.847 inmigrantes y 174.768 autóctonos de 15 a 64 años de edad, residentes en la Región Sanitaria Lleida. Mediciones principales Gasto en farmacia durante el año 2007, variables demográficas, zona de procedencia y área de residencia (urbana/rural). Resultados En todos los grupos terapéuticos, los individuos autóctonos gastaron más que los inmigrantes. En los hombres, la ratio de riesgo relativo de estar en el cuartil superior de gasto era de 3,2 (ICntervalo de confianza [IC] 95%: 2,96–3,44) en autóctonos respecto a inmigrantes y en las mujeres era de 2,1 (IC 95%: 1,97–2,27). Los inmigrantes de Europa del Este eran los que tenían un riesgo inferior de realizar gasto farmacéutico elevado (último cuartil), con diferencias estadísticamente significativas. Los residentes en el medio rural tenían riesgo superior de realizar gasto farmacéutico elevado respecto a los residentes en el medio urbano. Conclusión Se observaron desigualdades en el gasto en medicamentos entre inmigrantes y autóctonos. Futuros estudios, cualitativos o mixtos, deberían indagar qué factores se asocian a estas diferencias y proponer acciones dirigidas a reducirlas

Use of Primary Care Resources by Immigrants and the Autochthonous Persons Who Contact the Care Services in the City of Lleida,Spain

OBJECTIVE: To evaluate and compare the use of the different primary care (PC) services between immigrants and the indigenous population. DESIGN: Cross-sectional observation study of a population seen in (PC). SETTING: Patients seen by 15 PC doctors, in 5 basic health areas (BHA) in the city of Lleida, Spain, from March to August 2005. PARTICIPANTS: All immigrants (1,599 patients of immigrant origin) who seen during the study period were included. A random sample of 300 patients was taken from each of the 15 participating clinics (4,156 autochthonous patients). The autochthonous was considered as those whose country of origin is Spain and the immigrant population those who come from low and medium income countries, regardless of the time of residence in the BHA. PRIMARY MEASUREMENTS: Age, sex, type of visit made, and referrals made. Multinomial regression models were used to calculate the relative risk (RR) of having made visits. RESULTS: Immigrants have a higher probability to make 3 visits than the indigenous population, who would make 1 or 2 visits (RR, 1.23; 95% confidence interval, 1.04-1.91). The estimation of the RR of having made visits is higher in the immigrants for all categories, except nursing. CONCLUSIONS: Immigrants who come into contact with PC, make more frequent visits to the family doctor and gynaecology, and also have more complementary tests done. However, the frequency of use of the immigrant group for nursing visits seems to be les

Presence of acute and chronic renal failure in patients with paroxysmal nocturnal hemoglobinuria: results of a retrospective analysis from the Spanish PNH Registry

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, life-threatening blood disease. With the advent of eculizumab treatment, renal function has substantially improved, although no data from real-world clinical practice are available. An observational, retrospective, multicenter study was conducted in Spain on clinical data obtained from outpatient visits of patients with PNH (Spanish PNH Registry) who had experienced acute (ARF) or chronic (CRF) renal failure. Of the 128 patients registered (April 2014), 60 were diagnosed with classic PNH. Twenty-seven (45.0%) patients with a mean age of 48.5 (±16.2) years had renal failure, ARF or CRF, and were included in this study. Near half of the patients (n = 13; 48.1%) presented with ARF alone, 33.3% (n = 9) had CRF with episodes of ARF, while 18.5% (n = 5) were diagnosed with CRF alone. For patients with diagnosis of PNH and renal failure (n = 27), the median time to the first ARF episode was 6.5 (CI 95%; 2.2, 14.9) years, whereas the median to the diagnosis of CRF was 14.5 (CI 95%; 3.8, 19.2) years after the diagnosis of PNH. Patients with ARF (n = 22) were treated with eculizumab and did not experience new episodes of ARF, except for one patient with sepsis. Of the patients with CRF, two received treatment without experiencing further episodes of ARF. Sixteen patients who completed treatment (11 with ARF and 5 with ARF + CRF) recovered from the episode of ARF or from CRF. Of the remaining patients treated with eculizumab, one patient improved from stages III to II, three patients stabilized without showing disease progression, and one patient progressed from stages III to IV. Treatment with eculizumab in PNH patients has beneficial effects on renal function, preventing ARF and progression to CRF.This study was funded by Alexion Pharma Spain, SL (Barcelona, Spain).Peer reviewe