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Multicenter Study
. 2009 Feb;41(2):77-84.
doi: 10.1016/j.aprim.2008.09.008. Epub 2009 Feb 3.

[Use of resources and costs profile in patients with fibromyalgia or generalized anxiety disorder in primary care settings]

[Article in Spanish]
Antoni Sicras-Mainar  1 , Milagrosa Blanca-Tamayo, Ruth Navarro-Artieda, Javier Rejas-Gutiérrez
Affiliations
Multicenter Study

[Use of resources and costs profile in patients with fibromyalgia or generalized anxiety disorder in primary care settings]

[Article in Spanish]
Antoni Sicras-Mainar et al. Aten Primaria. 2009 Feb.

Abstract
in English, Spanish

Objective: To determine the use of services and costs in patients with Fibromyalgia (FM) or Generalized Anxiety Disorder (GAD) followed up in Primary Care (PC).

Design: A retrospective multicenter population-based study.

Setting: Five primary care clinics managed by Badalona Health Service.

Participants: Patients over 18 years seen in the 5 PC centers during the year 2006. Patients with and without GAD/FM were compared.

Measurements: Main outcomes measures were general, case/co-morbidity, health care use and primary care cost (visits, diagnostic/therapeutic tests and drugs).

Statistical analysis: logistic regression and ANCOVA (P<.05).

Results: There was a total of 63,349 patients, 1.4% (95% CI, 0.6%-2.2%) had a diagnosis of FM, and 5.3% (95% CI, 4.5%-6.1%) GAD. The average episodes/year and visits /year was higher in FM group compared to GAD group, with a marked difference observed vs. the reference group (8.3 vs. 7.2 and 4.6 episodes/year; and 12.9 vs. 12.1 and 7.4 visits/year; P <.001). FM was shown to be related to female gender (odds ratio [OR] = 16.8), dyslipidemia (OR = 1.5), and depressive syndrome (OR = 3.9) (P <.001 in all cases). GAD was related to age (OR = 1.1), female gender (OR = 2.2), high blood pressure (OR = 1.3), dyslipidemia (OR=1.2), smoking (OR = 1.4), depressive syndrome (OR = 1.2), and cardiovascular events (OR = 1.3) (P<.02 in all cases). After adjusting for age, gender and co-morbidities, mean annual direct ambulatory cost was 555.58 Euro for the reference group, 817.37 Euro for GAD, and 908.67 Euro for FM (P<.001).

Conclusions: Compared with reference group, a considerable use of health resources and costs was observed in patients with FM or TAG in medical practice in PC settings.

Objetivo: determinar el perfil de uso de servicios y costes en pacientes que demandan atención por fibromialgia (FM) o trastorno de ansiedad generalizada (TAG) en atención primaria (AP).

Diseño: estudio retrospectivo-multicéntrico.

Emplazamiento: cinco centros de AP urbanos, gestionados por Badalona Serveis Assistencials.

Participantes: pacientes mayoresde 18 años atendidos durante 2006. Se formó un grupo de referencia/poblacional con el resto de los pacientes.

Principales mediciones: generales, casuística/comorbilidad, utilización de recursos sanitarios y costes ambulatorios (visitas, procedimientos diagnósticos/terapéuticos y medicamentos). Análisis: regresión logística y ANCOVA.

Resultados: se atendió a 63.349 pacientes. El 1,4% (intervalo de confianza [IC] del 95%, 0,6%–2,2%) presentó FM y el 5,3% (IC del 95%, 4,5%–6,1%), TAG. El promedio de episodios atendidos/año y el de visitas realizadas/año fueron mayores en el grupo de FM que en el de TAG y que en el grupo poblacional (8,3 frente a 7,2 y 4,6 episodios/año; 12,9 frente a 12,1 y 7,4 visitas/año; p<0,001). La FM mostró relación con mujeres (odds ratio [OR]=16,8), dislipemia (OR=1,5) y síndrome depresivo (OR=3,9) (p<0,001), y el TAG, con la edad (OR=1,1), mujeres (OR=2,2), hipertensión arterial (OR=1,3), dislipemia (OR=1,2), fumadores (OR=1,4), síndrome depresivo (OR=1,2) y evento cardiovascular (OR=1,3) (p<0,02). El coste directo medio/anual corregido por edad, sexo y comorbilidades fue de 555,58 euros en el grupo de referencia, 817,37 euros en TAG y 908,67 euros en FM (p<0,001).

Conclusiones: los pacientes que requirieron atención por FM o TAG muestran un importante uso de recursos y costes sanitarios en el ámbito de la AP de salud. Los sujetos con TAG se asocian a un elevado número de comorbilidades.

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Figures

Esquema 1
Esquema 1
Esquema general del estudio. Diseño retrospectivo multicéntrico, realizado a todos los pacientes con fibromialgia y trastorno de ansiedad generalizada (TAG) en atención primaria durante 2006.
See this image and copyright information in PMC

References

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