Abstract：
OBJECTIVES:To assess the quality of prescriptions in primary care area through indicators established by a team of physicians and to analyze the relationship between these indicators and those used by the Spanish public health system (INSALUD) in the same area. METHODS:An observational, cross sectional study was performed in a primary care area in Asturias with 156,614 inhabitants and 9 health centers. An overall quality score was obtained for each of the physicians in the primary care area by using quality indicators and standards agreed on by the prescribers themselves. The relationship between the score obtained and the indicators normally used in the area by INSALUD and pharmaceutical cost was also analyzed. RESULTS:Mean compliance with the optimal standard was 29%. The mean overall quality score was 3.24. None of the physicians achieved the maximum score of 11. No significant association was found between the score and the indicators for drugs of limited clinical value. Adherence to the pharmaceutical guide for the area was positively correlated with quality (r = 0.44, p < 0.001). A negative linear association (p < 0.001) was found between the overall quality score and incurred cost. The adjusted coefficient of determination was 0.29. CONCLUSIONS:Poor prescribing quality was widespread. Indicators for drugs of limited clinical value, frequently used as a measure of quality, showed no relationship with quality. Adherence to the area's pharmaceutical guide remains a valid indicator of prescribing quality. Overall, there was a correlation between higher quality and lower prescribing cost, although this correlation was not found for individual physicians.
journal_name
Gac Sanitjournal_title
Gaceta sanitariaauthors
Gómez-Castro MJ,Arcos P,Rubiera G,Rigueira AIdoi
10.1016/s0213-9111(03)71773-7subject
Has Abstractpub_date
2003-09-01 00:00:00pages
375-83issue
5eissn
0213-9111issn
1578-1283pii
13053650journal_volume
17pub_type
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