Abstract

SANTOS, Maria Inês et al. An analysis of referrals from primary care to a pediatric hospital outpatient clinic. Rev Port Clin Geral [online]. 2011, vol.27, n.5, pp.422-432. ISSN 0870-7103.

Objectives: To determine the rate of referral of pediatric patients from the Grão Vasco Family Health Unit and the Viriato Family Health Units (FHU) to the São Teotónio Hospital (STH) pediatric outpatient clinic, to characterize these referrals, and to analyze the hospital’s response to these referral. Design: Cross-sectional Setting: Two family health units and one pediatric hospital outpatient clinic. Population: Children and adolescents under 18 years of age registered at the Grão Vasco and Viriato Family Health Units who attended the child and adolescent outpatient clinic at São Teotónio Hospital in 2009. Methods: We reviewed all pediatric referrals made during 2009. Data were collected by examining hospital and FHU clinical records. The variables assessed were: gender, age, number of children referred per physician, number of consultations per physician, physician’s years of practice, consult requested, reason for referral, initiator of referral, format of the referral letter, quality of referral letter, time to first consultation, and hospital feedback. Results: A total of 135 referrals were analyzed. 63% of patients referred were male. The mean age of referred patients was 6.1 ± 4.2 years. A referral rate of 1.1% (0.9; 1.3) was found. No significant correlation between years of clinical practice of the family physician and the rate of referral was found. The specialties with the greatest number of referrals were general pediatrics (35.6%) and pediatric surgery (33.3%). The referral letters were of good quality in 69.6% of cases. There was a significant association between the quality of letters and the referred specialty. There was a significant association between referrals to pediatric surgery and letters with reasonable or bad quality. The median waiting time for consultation was 92 days (83.6; 100.4). A reply to the referral from the hospital to the referring physician was found in 10.5% of cases. Conclusions: The referral rate in this study was lower than that found in other studies. The quality of referral letters and the hospital’s response time require improvement.

Keywords : Referral and Consultation; Communication; Primary Health Care; Hospital; Pediatrics; Quality of Health Care.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )