title: [An analysis of the evolution of consultation pressure in general medicine (1989-1993)].
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Descriptive and retrospective.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Dirección para la Gestión de Atención Primaria, Servei Valencià de Salut, Valencia.
authors.forename: F
authors.initials: F
authors.lastname: Ortiz
authors.forename: J
authors.initials: J
authors.lastname: Quiles
authors.forename: D
authors.initials: D
authors.lastname: Menéndez
authors.forename: F
authors.initials: F
authors.lastname: Peris
mesh_terms: D003151:Community Health Centers / Q000706:statistics & numerical data; D017598:Efficiency, Organizational / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000145:classification / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013030:Spain; D013997:Time Factors
vernacular_title: Análisis de la evolución de la presión asistencial en medicina general (1989-1993).