Derivación a las consultas de gastroenterología desde atención primaria: evaluación de dos programas |
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Authors: | Paola Quintas LorenzoAndré s Dacal Rivas,Marí a Francisco Gonzá lezJoaquí n Cubiella Ferná ndez,Luis Ló pez Sá nchezMarí a Jesú s Garcí a Garcí a,Javier Ferná ndez Seara |
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Affiliation: | a Servicio de Aparato Digestivo, Complexo Hospitalario de Ourense, Ourense, España b Servicio de Documentación Clínica y Control de Gestión, Complexo Hospitalario de Ourense, Ourense, España c Unidad de Apoyo a la Investigación, Complexo Hospitalario de Ourense, Ourense, España |
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Abstract: | ObjectivesTo 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.MethodsA 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.ResultsIn 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.ConclusionsIn 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. |
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Keywords: | Consulta de alta resolució n Unidad de endoscopia abierta Implementació n de guí as de prá ctica clí nica |
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