[Evolution of the demand for ambulatory neurological care and pathologies attended in neurology clinics in the health care district of Tortosa, Tarragona].
OBJECTIVE
An analysis was conducted to determine whether there were any changes in the demand for health care, demography and pathologies attended in outpatient departments within the health care district of Tortosa between 1997 and 2003.


METHODS
Data about the demand for and attendance at first neurology visits over the period 1997 and from March 2003 to February 2004 was collected prospectively. Information concerning age, sex, groups of pathologies, diagnoses, rates of requests for first visits, source of the demand and destination after the visit were compared.


RESULTS
Mean age rose from 49 to 56 years (p < 0.001). Patients above 70 years of age increased from 23.7% to 35.9% (p < 0.001), while in the population within the area the figure only rose from 15.8 to 17.1%. The proportion of females went up from 52 to 62% (p < 0.001). Demand (that is, the rate of requests for first visits per 1000 inhabitants per year among those over the age of 15) rose from 8.5 to 9.3, 9.8% (p = 0.03). Demand from primary care increased from 52 to 69% (p < 0.001). Cognitive disorders (6.5% and 15.9%) grew by 144.6% (p < 0.001). Headaches (23.9% and 24.1%), the largest diagnostic group, and non-neurological diagnoses (18% and 18.5%) remained unchanged (p = NS). No changes were observed in the number of discharges in the first visit: 22.8% and 21.1% (p = NS).


CONCLUSIONS
The most striking results are the increase in demand (mainly from primary care), the increased age of the population attended and the notable growth in the number of cognitive disorders. These quantitative and qualitative changes in the demand increase the need for resources.
Huerta-Villanueva
M
M
Sección de Neurología, Hospital Verge de la Cinta de Tortosa, Tortosa, Tarragona, Spain. mhuerta@gencat.net
Baiges-Octavio
J J
JJ
Martín-Ozaeta
G
G
Muñoz-Farjas
E
E
Rubio-Borrego
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology; D003953:Diagnosis-Related Groups; D005260:Female; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D009422:Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D009462:Neurology; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology