Ruiz F J, Piqueras V, Aznar J A
Centro de Salud Molina de Segura, Comunidad Autónoma de la Región de Murcia.
Aten Primaria. 1995 May 15;15(8):491-7.
To evaluate the quality of referral from Primary Care to Mental Health and its relationship to the illness referred.
A descriptive retrospective study over 4 years on the quality of the process.
Mental Health Centre II in the Autonomous Community of Murcia.
209 patients referred by three Primary Care teams.
91.4% of patients (C.I. 95%: 100%, 81.1%) were accepted with a referral report. 97.9% (C.I. 95%: 100%, 87.8%) presented a reason for psychiatric consultation. The report included the clinical history of the illness in 58.1% of cases (C.I. 95%: 70.3%, 45.9%); a diagnostic opinion was given in 79.6% (C.I. 95%: 91.1%, 68%); and 37.2% (C.I. 95%: 49.3%, 25%) were referred with a request for a specific consultation. 68.4% of the referrals (C.I. 95%: 81.8%, 54.9%) coincided with the Mental Health diagnosis. It was observed that among the most commonly referred pathologies: anxiety disorders (31.6%), affective (28.8%), personality (7.7%), psychotic (5.3%), and adaptive disorders (5.3%); diagnoses were commonly made for affective or anxiety disorders (p < 0.0001); the specific cause of referral of anxiety disorders was recorded (p < 0.01); and in cases of psychotic and personality disorders, the diagnoses did not coincide (p < 0.001).
Referral to Mental Health can be improved, fundamentally by sending a report which includes the clinical history and the reason for referral. It is common to express a diagnostic opinion on affective and anxiety disorders, to note a specific reason for referral in the case of anxiety disorders and not to specify personality and psychotic disorders.
评估从初级保健机构转诊至精神卫生机构的质量及其与所转诊疾病的关系。
一项关于该过程质量的为期4年的描述性回顾性研究。
穆尔西亚自治区的第二精神卫生中心。
由三个初级保健团队转诊的209名患者。
91.4%的患者（95%置信区间：100%，81.1%）凭转诊报告被接收。97.9%（95%置信区间：100%，87.8%）的患者有精神科会诊原因。报告在58.1%的病例中包含疾病临床病史（95%置信区间：70.3%，45.9%）；79.6%（95%置信区间：91.1%，68%）给出了诊断意见；37.2%（95%置信区间：49.3%，25%）转诊时附有特定会诊请求。68.4%的转诊（95%置信区间：81.8%，54.9%）与精神卫生诊断相符。观察发现，在最常转诊的病症中：焦虑症（31.6%）、情感性疾病（28.8%）、人格障碍（7.7%）、精神病性障碍（5.3%）和适应性障碍（5.3%）；情感性或焦虑症诊断较为常见（p<0.0001）；记录了焦虑症转诊的具体原因（p<0.01）；而在精神病性和人格障碍病例中，诊断不相符（p<0.001）。
转诊至精神卫生机构的情况可得到改善，根本措施是发送包含临床病史和转诊原因的报告。对情感性和焦虑症表达诊断意见、记录焦虑症转诊的具体原因以及不明确人格和精神病性障碍的情况较为常见。
