Patterns of health resources use and costs in patients with neurological disorders in primary care

AIM: To determine the pattern of services use and costs of patients requiring care for neurological disorders (ND) in primary care in the context of routine clinical practice. PATIENTS AND METHODS: We performed a retrospective study of all patients older consulting primary care at least once for ND, attended by five primary care teams in 2006. A comparative group was formed with the remaining outpatients without ND. The main measurements were age, gender, case-mix/comorbidity, Charlson index (severity) and health resource utilization and corresponding outpatient costs (drugs, diagnostic tests and visits). Multiple logistic regression analysis and ANCOVA models were applied (Bonferroni adjust), p < 0.05. RESULTS: A total of 80,775 patients were assessed, of which 19,423 had some type of ND (24%; 95% CI = 23.7-24.3%). Patients consulting for ND had a greater number of health problems (6.1 vs. 4.3; p < 0.0001) and higher resource consumption, mainly all-type medical visits/patient/year (9.9 vs. 7.2; p < 0.0001). The mean annual cost per patient was higher for patients with ND (708.25 vs. 443.10 euros, p < 0.0001), and this difference remained significant after adjusting by age, sex and comorbidities, with adjusts cost of 932.87 vs. 712.38 euros. All components of outpatient management costs were significantly higher in the ND group. CONCLUSION: Outpatients seeking care for some type of ND had a high number of comorbidities and showed greater annual cost per patient in the primary care setting.