Referral to secondary care

Abstract

Introduction: The referral process between Primary and Secondary Health Care is of great interest, especially because of aspects related to the quality of the care provided and economic ones. The European study of referrals revealed a referral rate in Portugal of 5,56%. In Portugal there are no studies about the quality of the referrals. The Health Local Unit of Matosinhos intends to give global care to its patients connecting Primary Care Centres with the Hospital. In terms of referral, this connection must be perfected. Objectives: To determine the referral rate, to characterize the referred population, to evaluate the characteristics of the referrals, to describe and analyse the Secondary Health Cares response. Methodology: Transversal analytic study. Gathering of the number of referrals of the Senhora da Hora Health Centre in 2003. Randomly selected sample of 400 referrals from the list of referrals made to the Hospital Pedro Hispano. Determination of the samples descriptive statistics and the use of the 2 test for frequency comparison (a = 0,05). Results: The referral rate was 10,1%. The average age of the referred population was 45,3 years, with 61,8% being female. The more referred specialities were the name of the patient (98,9%), the referral objective (92,8%) and date (94,8%). However the majority did not mention the usual medication (71,3%), the description of the physical exam (51,5%) or the physicians identification (52,3%). In 50,8% of the cases the medical appointment was made one to six months after the referral. There was return information in 26,3% of the referrals. Conclusions: This study revealed failures in the articulation of health care. The physician should take into account that the referral/return letter is a primordial vehicle of communication and it has to be perfected, to improve the quality of the care provided. Network information systems and protocol rules may contribute to improve the articulation of the care provided.