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[Variability in preventive activities among primary care teams in Catalonia. Application of a multilevel analysis]
1Servei Català de la Salut, Travessera de les Corts, 131-159, Edifici Olimpia, 08028 Barcelona, Spain. jfuste@olimpia.scs.es
Objectives:
To determine whether variability exists among primary care teams (PCTs) in Catalonia in opportunistic screening activities (screening for smoking, drinking, hypertension and tetanus vaccination) and to analyze the explanatory factors in the individual characteristics of the population treated and the characteristics of the PCT.
Methods:
A multilevel analysis with individual and PCT explanatory variables was performed. The data were draw from a sample of 3,000 clinical histories from the adult population treated in 1995 in 30 PCTs from the restructured primary care network in Catalonia and from PCT characteristics.
Results:
The recording of preventive activities in the clinical histories increased with the number of risk factors and/or diseases diagnosed, the number of other preventive activities recorded, and age. Recording of arterial pressure was more frequent in women while the remaining preventive activities were more frequent in men. Workload impeded opportunistic detection. Greater recording of antitetanus vaccination was associated with the number of years that the PCT had been functioning and with wider geographical area. Recording of smoking was higher in urban areas.
Conclusions:
Variability in opportunistic detection exists among PCTs in Catalonia. The characteristics of the PCT and the population treated that explain part of this variability are identified. Lower workload favors preventive activities in primary care.