Impacto de la implantación del modelo de dirección clínica en atención primaria del Institut Català de la Salut sobre la salud cardiovascular en la provincia de Tarragona

• Autores: Carina Aguilar Martín
• Directores de la Tesis: Jordi Bladé Creixenti (dir. tes.), Josep Lluís Piñol Moreso (dir. tes.)
• Lectura: En la Universitat Rovira i Virgili ( España ) en 2013
• Idioma: español
• Tribunal Calificador de la Tesis: Maria Victoria Arija Val (presid.), Enric Aragonés Benaiges (secret.), Vicente F. Gil Guillén (voc.)
• Materias:
  • Ciencias médicas
    • Medicina interna
      • Cardiología
    • Patología
      • Patología cardiovascular
    • Medicina preventiva
    • Salud publica
• Enlaces
  • Tesis en acceso abierto en: TDX
• Resumen

  • The Institut Català de la Salut (ICS) implemented the model of Clinical Governance in Primary Health Care in 2001 in order to improve its services and the medical practice. A good way to carry out these implementations is by means of interventions. Two of the mostly used strategies to improve clinical practice are audits and feedback of information. OBJECTIVE To evaluate the impact of the implementation of the Clinical Governance model in Primary Health Care of the ICS on the cardiovascular health and its associated variables. MATERIAL AND METHODS Cohorts prospective study (2001-2011) to evaluate the impact of the implementation of the Clinical Governance model on the population of the province of Tarragona. In this study took part 19 Primary Health Care centres, 96 medical professionals and 1878 patients. The effect of this implantation was evaluated globally and according to the level of the feedback information received, categorized into two groups, high and low. RESULTS Ten years after the implementation there was a general improvement regarding screening, percentage of diagnosis and control of cardiovascular risk factors. The risk of suffering from adjusted cardiovascular diseases and mortality if exposed to a low level of feedback was of HR=1,555(1,060-2,277) and of HR=1,808(1,141-2,865) respectively. CONCLUSION The implementation of the Clinical Governance model in Primary Health Care of the ICS in the province of Tarragona represented an improvement in the cardiovascular health and mortality, above all, in the group with a high level of feedback of information.