[Evaluation of referrals in primary care].

OBJECTIVE

To study the process of referral from primary care in a health area in Madrid. The second objective was to evaluate the trends in the referral process.

DESIGN

Observational, descriptive and cross-sectional study.

SETTING

Three urban health centers in the Area 2.

PARTICIPANTS

All referrals made by 13 doctors during 3 consecutive weeks. The total number of visits attended were 6012. The study was realized between February 2002 and January 2003.

MAIN MEASUREMENTS

Patient, doctor and referral characteristics on every referral.

RESULTS

349 referrals were studied. The rate of referral 5.8% (5.21-6.39). The referred patients, 65.5% women, medium age 50.6+/-21. The specialties that received more referrals are gynecologist, ophthalmology, dermatology, otorhinolaryngology, rehabilitation, orthopedic surgeon and general surgeon. The most common conditions referred, 25.6% of all referrals, are gynecologist check, blindness, other illnesses of subcutaneous cellular tissue, arthrosis, joint pain, diabetes, benign neoplasm of skin, depression and hypoacusis. 92.3% of the referrals were sent to the specialist center. 89.7% were normal (no urgent). The reason for referral was to accede to the patient's request in 18.3% of the referrals.

CONCLUSIONS

The process of referral is similar to previous studies. Although people are more participative, have more information and the defensive medicine is increasing, the process of referral have not changed.