ABS50: Study of resources in asthma and COPD in the community of Madrid (Spain)

Abstract

Introduction:

Respiratory medicine is developing in primary care. We describe the resources available. In a second phase, we will study health results.

Aims and objectives:

To learn about resources (infrastructure and process) related with Asthma and COPD in the public centers of the Community of Madrid (Spain). Subjects and methodology: A descriptive, cross-sectional study. A postal survey addressed (2 mailings) to the leaders of all the health centers (227), between November (2000) and April (2001). Response: 156 (68.7%). A previous study over 44 coordinators (nominal group), added 10 items and changed 4.Variables of infrastructure: existence and/or revision of cardiopulmonary resuscitation equipment (CPRE), spirometry, pulse oximeter, peak flow, inhalation devices and educational tools. Variables of process: existence of protocol, quality control, health education, provision of systems, continued education, waiting list.

Results:

Spirometry was available in 102 centers (65.4%), calibrated habitually in 60 (38.5%), there was CPRE in 142 (91%), pulse oximeter in 19 (12.2%). peak flow in 53.8%, 27.6% and 43.6% of the medical consultations, infirmary and emergency departments. There was an asthma protocol in 53 centers (34%) and COPD in 131 (84%). There was quality control in asthma in 10 centers (6.4%) and COPD in 52 (38.3%). There was grouped education in asthma in 22.4% and 19.2% in COPD. 60.3% of asthmatics and 98.7% of COPD patients were referred to pneumology. 7.1% of the asthmatic patients waited less than 31 days to be attended in allergy, as opposed to 49.9% in pneumology.

Conclusions:

Some deficiencies in infrastructure and process were detected with evidence of less development in the attention to the asthmatic patient. Also, there was little activity in respect of health education.

Conflict of interest and funding

The authors work as family doctors in the National Health Service, Community of Madrid. Funding: None.