Estudio descriptivo longitudinal y de concordancia diagnóstica entre Atención Primaria y Psicología del Programa de Soporte a Atención Primaria. Abstract

Abstract

<p><span style="font-family: Times New Roman;">Background: The objective was to describe the characteristics of a primary support program (PSP) and to analyze diagnostic concordance between primary care physicians (PCP) and psychologists over three years. Material and method: A descriptive, longitudinal prospective study over three years at five primary care centers in Barcelona. The sample was 1722 patients referred to psychology services. Descriptive statistics used to analyze sociodemographic variables and Cohen's Kappa to assess agreement. Results: The average waiting time between referral and first visit was 37.54 days. Stable over the three years were the number of highs (34%), the number of cases of not presenting to first visit (21.4%), treatment dropout (19.9%), and referrals to other services (19.5%). There was a low overall concordance between PCP and psychologist. PCP most frequently diagnosed anxiety disorder. Psychologists most frequently diagnosed depression and anxiety. The highest concordance (2010:  0.343, 2011: 0.456, 2012: 0.662 Kappa Index) was observed in the diagnosis of eating behavior disorders followed by depression (2010: 0.302, 2011: 0.367, 2012: 0.362) and anxiety (2010: 0.245, 2011: 0.278, 2012: 0.296). Conclusions: PSP offers specialized brief interventions in primary care. Progressive increase of slight concordance was observed between professionals, while remaining close to the baseline percentage, indicating the need for increased opportunities for consultation.</span></p>