Grupos de morbilidad ajustados: características y comorbilidades de los pacientes crónicos según nivel de riesgo en Atención Primaria

Cortés, Juan José Baztán; Cura-González, Isabel del; Martínez-Martín, Miguel; López-Rodríguez, Carmen; Jaime-Sisó, María Ángeles; Súarez-Fernández, Carmen

doi:10.1016/j.aprim.2018.12.007

Cited by 12 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The variable which had a greatest impact on the PC services use was the high risk level. Thus, the AMG high risk level also help to identify patients with more need of care as happened in adult patients too and unlike pediatric patients where high risk level was not associated with more utilization of PC services [ 11 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to these AMG risk level and with the knowledge of the patient and their context, the PC health professional responsible for the patient care determines the level of intervention to assign in the PC electronic clinical record and, therefore, the care plan to implement in order to offer a more personalized attention. Although there are studies on the usefulness of AMG and the stratification of chronic patients into different risk levels in the general population [ 16 , 19 , 20 ], there is little information on its specific use in the geriatric population [ 17 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic diseases in the geriatric population: morbidity and use of primary care services according to risk level

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Geriatric patients have significant morbidity and greater needs for care and assistance. The objective of this study was to describe the characteristics, morbidity, and use of services in primary care (PC) of patients with chronic diseases older than 65 years according to their risk level assigned by the adjusted morbidity groups (AMG) and to analyse the factors associated with the use of PC services. Methods This was a cross-sectional descriptive observational study. Patients older than 65 years from a healthcare service area, classified as chronically ill by the AMG classification system of the PC electronic medical record of the Community of Madrid, were included. Sociodemographic, clinical-care, and PC service utilization variables were collected. Univariate, bivariate and multivariate analyses were done. Results A total of 3292 chronic patients older than 65 years were identified, of whom 1628 (49.5%) were low risk, 1293 (39.3%) were medium risk and 371 (11.3%) were high risk. Their mean age was 78.1 (SD = 8.1) years and 2167 (65.8%) were women. Their mean number of chronic diseases was 3.8 (SD = 2), 89.4% had multimorbidity and 1550 (47.1%) were polymedicated. The mean number of contacts/year with PC was 19.5 (SD = 18.2) [men: 19.4 (SD = 19.8); women: 19.5 (SD = 17.4)]. The mean number of contacts/year in people over 85 years was 25.2 (SD = 19.6); in people 76–85 years old, it was 22.1 (SD = 20.3); and in people 66–75 years old, it was 14.5 (SD = 13.9). The factors associated with greater use of services were age (B coefficient [BC] = 0.3; 95%CI = 0.2–0.4), high risk level (BC = 1.9; 95%CI =0.4–3.2), weight of complexity (BC = 0.7; 95%CI = 0.5–0.8), and ≥ 4 chronic diseases (BC = 0.7; 95%CI = 0.3–1.1). Conclusions In the geriatric population, we found a high number of patients with chronic diseases and there were three levels of risk by AMG with differences in characteristics, morbidity, and use of PC services. The greatest use of services was by patients with older age, high risk level, greater weight of complexity and ≥ 4 chronic diseases. Further research is needed to develop an intervention model more adapted to the reality of the geriatric population based on risk levels by AMG.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic diseases in the geriatric population: morbidity and use of primary care services according to risk level

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although there are studies on the usefulness of AMG and the stratification of chronic patients into different risk levels in the general population in PC [ 8 , 20 , 21 ], there is little information about the differences between PC and HC services utilization according to AMG risk levels.…”

Section: Introductionmentioning

confidence: 99%

Use of primary and hospital care health services by chronic patients according to risk level by adjusted morbidity groups

Cortés

Soria-Ruiz-Ogarrio

Martínez-Cuevas

et al. 2021

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background Patients with chronic diseases have increased needs for assistance and care. The objective of this study was to describe the characteristics and use of primary care (PC) and hospital care (HC) health services by chronic patients according to risk level based on adjusted morbidity groups (AMG) and to analyze the associated factors. Methods Cross-sectional descriptive observational study. Patients from a basic health area classified as chronically ill by the AMG classification system of the Madrid PC electronic medical record were included. Sociodemographic, clinical-care characteristics (classified as predisposing factors or need factors) and service utilization variables were collected. Univariate, bivariate and simple linear regression analyses were performed. Results The sample consisted of 9866 chronic patients and 8332 (84.4%) used health services. Of these service users, 63% were women, mean age was 55.7 (SD = 20.8), 439 (5.3%) were high risk, 1746 (21.2%) were medium risk, and 6041(73.4%) were low risk. A total of 8226 (98.7%) were PC users, and 4284 (51.4%) were HC users. The average number of annual contacts with PC was 13.9 (SD = 15); the average number of contacts with HC was 4.8 (SD = 6.2). Predisposing factors associated with services utilization at both care levels were: age (B coefficient [BC] = 0.03 and 0.018, 95% CI = 0.017–0.052 and 0.008–0.028, respectively, for PC and HC) and Spanish origin (BC = 0.962 and 3.396, 95% CI = 0.198–1.726 and 2.722–4.070); need factors included: palliative care (BC = 10,492 and 5047; 95% CI = 6457–14,526 and 3098-6995), high risk (BC = 4631 and 2730, 95% CI = 3022–6241 and 1.949–3.512), number of chronic diseases (BC = 1.291 and 0.222, 95% CI = 1.068–1.51 and 0.103–0.341) and neoplasms (BC = 2.989 and 4.309, 95% CI = 1.659–4.319 and 3.629–4.989). Conclusions The characteristics and PC and HC service utilization of chronic patients were different and varied according to their AMG risk level. There was greater use of PC services than HC services, although utilization of both levels of care was high. Service use was related to predisposing factors such as age and country of origin and, above all, to need factors such as immobility, high risk, and number and type of chronic diseases that require follow-up and palliative care.

show abstract

“…En México, los estudios de Barrio-Cortes et al, (2020); Lara Rivera, Parra Bracamonte, & Lopez Villalobos, (2021); Nuñez Medina, (2021); Sánchez-Talanquer et al, (2020); Villerías Alarcón & Juárez Gutiérrez, (2020) han logrado identificar las entidades con mayores tasas de incidencia, de defunciones y de letalidad, así como los principales factores de riesgo y comorbilidades que afectan a la población mexicana, al respecto Sánchez-Talanquer et al apuntan que el 66.6% de las personas fallecidas por COVID-19 padecían al menos una de las tres principales comorbilidades: hipertensión, diabetes y obesidad.…”

Section: Antecedentesunclassified

Distribución espacial de la COVID-19 con principales comorbilidades en la Megalópolis de la Zona Metropolitana del Valle de México.

De Fermin Sosa,

Santana Juárez,

Santana Castañeda

2022

Proyección

View full text Add to dashboard Cite

La presente investigación tiene como objetivo analizar la distribución y autocorrelación espacial de las defunciones por COVID-19, así como la letalidad asociada a tres principales comorbilidades (diabetes, hipertensión y obesidad), en la Megalópolis de la Zona Metropolitana del Valle de México (MZMVM), en el 2021. El método consistió en el cálculo de cuatro indicadores (asociados con COVID-19 y cada comorbilidad): tasas de prevalencia, de mortalidad, de mortalidad específica y de letalidad. A partir de la letalidad se calculó el índice de LISA y se identificaron clústeres con valores altos, bajos y atípicos. Los resultados muestran que la mortalidad por COVID-19 presenta un patrón de distribución espacial diferente al compararla con la letalidad: las tasas altas de mortalidad y prevalencia se distribuyeron en las zonas más densamente pobladas, en cambio, las tasas altas de letalidad se localizaron en las zonas metropolitanas circundantes al Valle de México. De acuerdo con el indicador de LISA de la tasa de letalidad, los municipios de Toluca y Capulhuac conformaron clústeres coincidentes de tipo “alto-alto”, en relación con diabetes e hipertensión; mientras que, para hipertensión y obesidad, se conformó el clúster en torno a San Agustín Tlaxiaca

show abstract

Grupos de morbilidad ajustados: características y comorbilidades de los pacientes crónicos según nivel de riesgo en Atención Primaria

Cited by 12 publications

References 26 publications

Chronic diseases in the geriatric population: morbidity and use of primary care services according to risk level

Chronic diseases in the geriatric population: morbidity and use of primary care services according to risk level

Use of primary and hospital care health services by chronic patients according to risk level by adjusted morbidity groups

Distribución espacial de la COVID-19 con principales comorbilidades en la Megalópolis de la Zona Metropolitana del Valle de México.

Contact Info

Product

Resources

About