• Carles Blay, Joan Carles Martori, Esther Limon, Cristina Lasmarías, Ramon Oller, and Xavier Gómez-Batiste.
• Facultad de Medicina, Universitat de Vic-Universitat Central de Catalunya, Vic, España; Institut Català de la Salut, Vic, España.
• Aten Primaria. 2019 Jun 1; 51 (6): 359366359-366.

ObjectiveTo describe the use of health resources of people with advanced chronicity, quantifying and characterizing its cost to suggest improvements in health care models.DesignObservational, analytical and prospective study during 3 years of a cohort of people with advanced chronicity.LocationThree primary care teams (EAP) of Osona, Cataluña.Participants224 people identified as advanced patients through a systematic population strategy.Main MeasurementsAge, sex, type of home, end-of-life trajectory; use, type and cost of resources in primary care, emergencies, palliative teams or hospitalization (in acute or intermediate care).ResultsPatients made an average of 1.1 admissions per year (average stay=6 days), 74% in intermediate care hospitals. They lived in the community 93.4% of time, carrying out 1 weekly contact with the EAP (45.1% home care). The average daily cost was 19.4euros, the main chapters were intermediate care hospitalizations (36.5%), EAP activity (29.4%) and admissions in acute hospitals (28.6%). Factors determining a potential lower cost are frailty/dementia as trajectory (p<0.001), living in a nursing-home facility (p<0.001) and over-aging (p<0.001). There are certain differences in the behavior of the EAP related to the global cost and to community resources (p<0.05).ConclusionsConsumption in intermediate hospitalization and primary care is more relevant than stays in acute care centers. Nursing-homes and home-care strategies are important to attend effectively and efficiently, especially when primary care teams get ready for it.Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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