AAccess to secondary care from Serpa Health Centre

Abstract

Objective: 1) To characterise access to secondary health care services (SHCS) for patients from a rural health centre outpost in the Alentejo hinterland. 2) To compare current results with those from another study conducted ten years earlier. Type of Study: Descriptive, cross-sectional. Setting: Vale de Vargo outpost, Serpa Health Centre. Population: Patients referred to SHCS by their family doctor. Methods: Throughout 1997, for each patient referred on to SHCS, the family doctor filled out a form during the consultation. The form was later completed with: date of consultants appointment, actual completion of referral, and whether a feedback letter was sent on the patients return. Results: 105 patients were referred to 134 consultant appointments. The referral rate was 5.87%. Most referrals were for: ophthalmology (36%), gynaecology (9%), and general surgery (8%). More often patients were referred to: Beja Hospital (39%), Serpa Hospital (32%), and the Portuguese Institute of Oncology in Lisbon. Of all referrals, an appointment was made for only 76%, and a mere 68% were actually completed. Average waiting time for appointments was 82.5 days (SD±95.7 days). At the 8th day 94% of patients were waiting for an appointment, 47% were still waiting 12 weeks on. In 24% of cases an appointment could not be made at all. Only 27% of patients brought a feedback letter to their family doctor. These results are worse than those from a similar study conducted by the same author 10 years ago. Other European studies also show better results. Conclusion: Access for the patients in this study proved to be worse than in other national studies, which in turn are the worst in Europe. Further studies are urgently needed on primary-secondary health care articulation, so that causes may be identified. Professionals from both levels of care should become involved in a strategy for change which should be clearly taken up by management.