NDLI: Derivación a las consultas de gastroenterología desde atención primaria: evaluación de dos programas.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Quintas Lorenzo, Paola Dacal Rivas, Andrés González, María Francisco Cubiella Fernández, Joaquín López Sánchez, Luis García García, María Jesús Fernández Seara, Javier
Spatial Coverage	Spain
Description	Author Affiliation: Quintas Lorenzo P ( Servicio de Aparato Digestivo, Complexo Hospitalario de Ourense, Ourense, España.)
Abstract	OBJECTIVES: To analyze the effect of implementing a high-resolution clinic (HRC) and an increasing resolution capacity program in primary care (IRCPPC) for referrals to a gastroenterology outpatient clinic from primary care and the resources used. METHODS: A retrospective and observational study based on a review of referral sheets and databases was performed. We analyzed the number and reason for referrals, delay times and resource consumption in two periods: before (first 4 months of 2007) and after (first 4 months of 2009) the launch of the IRCPPC and HRC. RESULTS: In the first and second periods, 881 and 1076 patients, respectively, referred from primary health care were evaluated in the gastroenterology clinic, with a decrease in the delay time in the second period (80.8 ± 64.34 days vs 36.1 ± 29.12 days, p < 0.001). The most frequent reasons for referral were dyspepsia (27.7%), high-risk of colorectal cancer (17.1%), disturbance of bowel rhythm (18.2%), abdominal pain (16%), and gastroesophageal reflux (11.2%), with no differences between the two periods. Although delay times until the first visit (10.8 ± 9.03 days vs 42.8 ± 28.67 days, p < 0.001) and until discharge (39.6 ± 80.65 days vs 128.6 ± 135.34 days, p < 0.001) were lower in referrals to the HRC, the number of visits (3.6 ± 2.20 vs 3.2 ± 1.95, p = 0.015) and the cost of referrals (592.7 ± 421.50 vs 486.0 ± 309.66 , p < 0.001) was higher. CONCLUSIONS: In the study period the number of referrals increased, while the delay time decreased. Although the HRC reduces delay times, it is associated with an increase in health resource use.
Related Links	http://www.scielosp.org/scielo.php?script=sci_arttext&nrm=iso&lng=pt&tlng=pt&pid=S0213-91112011000600006
File Format	HTM / HTML
ISSN	02139111
Issue Number	6
Volume Number	25
e-ISSN	15781283
Journal	Gaceta Sanitaria
Language	Spanish
Publisher	Elsevier
Publisher Date	2011-11-01
Publisher Place	Spain
Access Restriction	Subscribed
Subject Keyword	Discipline Public Health Gastroenterology Organization & Administration Outpatient Clinics, Hospital Primary Health Care Referral And Consultation Adult Aged Ambulatory Care Economics Statistics & Numerical Data Databases, Factual Diagnosis-related Groups Diagnostic Techniques, Digestive System Utilization Endoscopy, Gastrointestinal Female Guideline Adherence Health Resources Humans Male Middle Aged Practice Guidelines As Topic Program Evaluation Retrospective Studies Spain Time Factors Comparative Study English Abstract Journal Article
Alternative Title	Referrals to a gastroenterology outpatient clinic from primary care: evaluation of two programs
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health

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