Aim of the study:

To determine the referral rate of adult patients to the Centro Hospitalar Tondela-Viseu (CHTV) outpatient clinic; evaluate the quality of the referral information based on Guia de Referenciação do ACeS Dão Lafões à Consulta Externa do Centro Hospitalar Tondela-Viseu (GR); compare referrals between chosen family health units (FHU); analyze referrals response times by secondary care; verify if the family physician receives feedback after discharge.

Methods:

This retrospective cohort study protocol will be conducted in six FHU from ACeS Dão Lafões (USF Cândido Figueiredo, USF Montemuro, USF Viseu Cidade, USF Tondela, UCSP São Pedro do Sul and UCSP Vouzela) and in CHTV. The population studied will be all the patients enrolled in the HU, with the age of 18 or older by January 2018. There will be a random selection of 8000 samples. The referrals made to CHTV during the year 2018 will be evaluated. Data were collected by examining hospital and FHU clinical records. The variables assessed were sex, age, family health unit, regular patient, number of referrals, referral rate per appointment, referral rate of regular patients, requested consultation, referral quality, time to response, response description, response evaluation, time to the first consultation, and feedback information. The study will be conducted during the last trimester of 2021, evaluating referrals from the year 2018.

Discussion:

The results of the study will add to a better understanding of the process and quality of referrals made by primary care physicians and the quality of response given by secondary care, concerning response times and post-discharge care. The study will allow us to evaluate if there are discrepancies in the referral processes between different FHUs. Another differentiator feature of the study is the way the data is analyzed to measure hospital response which will allow for estimating more precisely the time until the first consultation. This study may become a starting point for a continuous improvement cycle of the quality of the referral processes between these two healthcare settings.

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