[Evaluation of the quality of communication between levels of care through the inter-consultation document].

OBJECTIVES

To evaluate the quality and improvement of compliance in the inter-consultation documents of the primary care team (PCT).

DESIGN

Entire care cycle.

SETTING

Primary care (PC).

MEASUREMENTS

Dimension studied: scientific-technical quality.

SUBJECTS

all the inter-consultation documents (ID-1) sent by PC doctors from Irun Health Centre to specialist clinics over a 15-day period. 223 ID-1 for evaluation in April 1998, and 287 for re-evaluation in October 1998. Type of evaluation: retrospective.

SOURCE OF DATA

inter-consultation documents and clinical records.

CRITERIA

explicit and standard. Corrective measures: educational (discussion of results in meeting of the PCT).

RESULTS

A statistically significant improvement was found at the re-evaluation: basic personal details (91.5%-96.8%), legibility (86%-92.7%), medical history and/or customary medication (35.9%-50%) and symptoms (77.8%-87.2%). Good quality levels rose from 20.6% to 42.5%; and bad quality levels fell from 40.8% to 33.4%. 22.2% of our referrals received a reply. 34% of the lack of replies was because of no report from the specialist, 47.8% were attributed to the patient or circuit, and 18% of the patients were awaiting test results.

CONCLUSIONS

The information supplied in the ID-1 improved significantly after the quality cycle. Knowing our habitual working practice can serve to stimulate improvement. The criteria we complied with least were: reference to personal antecedents and/or habitual medication, physical examination, and therapeutic measures employed. There was a huge loss of information in the replies to our referrals.