Prevention and performance indicators - How much time is left?

Abstract

Objectives: To determine the number of office visits needed per year to perform selected preventive procedures and, in patients with diabetes or hypertension, meet performance indicators related with follow-up. Methods: Descriptive study based on the list of patients of a family doctor (1587 patients). We considered the follow-up of children and teenagers, pregnant women, patients with diabetes or hypertension, and screening for breast, cervical and colon cancers, hypertension, dyslipidemia and obesity. Appropriate follow-up for each situation was defined according to clinical practice guidelines, the coverage rate contractually agreed by the clinic and performance indicators defined by the Portuguese Mission for Primary Health Care. We considered the performance of each activity separately or of multiple preventive and followup activities in the same visit. Results: If they were held separately, we would need 2848.5 office visits to carry out the defined preventive activities and follow-up of patients with diabetes or hypertension. If multiple activities were performed in the same visit, we would require 2008.9 consultations per year (50.6% of the total in the previous year). Conclusions: Implementation of preventive activities and compliance with performance indicators require a considerable amount of time. Before assigning more tasks to family physicians, the weight of each on existing resources should be assessed.