[An analysis of the evolution of consultation pressure in general medicine (1989-1993)]

To improve the understanding of attendance pressure, its evolution over time and its relationship with the indicators of demand, use and age of the resources.

Descriptive and retrospective.

Primary care centres with an appointment system in the Community of Valencia. There were 6,756 valid registers of the monthly attendance pressure (1989-1993) available.

Attendance pressure has an extremely dispersed distribution. Behaviour which is constant in its evolution over time does exist, which allows a characteristic curve, repeated every year, to be defined: descent in August, two peaks in October and January and a third "mobile" peak around March and April. Mathematical equality between attendance pressure and the product of three factors has been obtained: duration of use per procedure x intensity of repeated use per procedure x ratio equivalent day. The analysis of the monthly evolution of each one of these three "components" helps understand changes in pressure. These "components" are also modified by the type and age of centre.

The wide dispersion of the results of technical productivity (attendance pressure), and the evidence of its change in composition over time and according to the care model offer important scope for management. It also creates the need for an explanatory model which includes the variables which determine both the attendance pressure and a method for altering it.