Análise de estratégia para aplicação de sistema eletrônico na referência e contrarreferência nos serviços de saúde
Data
2013-12-02
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Universidade Federal de Goiás
Resumo
Introduction: In recent times, the Brazilian Unified Health System has undergone
several innovations in management, organizing, financing and services. In this
context, looms as a major strengthening of the system of Primary Health Care, which
has demonstrated the essence of the effectiveness of care, enabling a holistic
approach to people. In this sense, it is necessary an efficient monitoring of the patient
by means of the reference and counter reference. Objective: To analyze strategies
to implement the Electronic System Reference and counter reference in the Family
Health Unit (FHU) in the city of Anápolis, Goiás. Material and Methods: The study
was a prospective, nonrandomized intervention, developed in two of the three FHU
research. The experimental and control groups were chosen on the basis of
convenience. Visits were made by the researcher to the health units, explanations
about the research and requests for assistance to the professionals. The
interventions were performed by means of encouragement and guidance to
professionals and patients. It was used among the instruments: Sheets Guidelines
and Flow and Letter Search. In one of FHU Intervention was made available the
Electronic Reference and counter reference. We carried out the monitoring, the FHU
study and the National Regulatory System (SISREG), the flow of patients referred to
specialists in the period from 1 August 2012 to 1 December 2012. Visits to medical
specialists were made who treated the patients referred and also active search for
patients who have not returned or returned without the counter reference - FHU
source. It was evaluated the number of references, counter reference and reasons
for non-return of patients and counter reference to the three FHU from study. Data
were analyzed using STATA version 11.0. Results: Of the total of 6,218 medical
consultations, it was performed 532 accompaniments to specialists physicians and
492 patients accompaniments. The referral rate was 8.56 %. They were requested
and scheduled more appointments in FHU intervention. Of referrals made, 54.27 %
were scheduled consultations. Of these, 11.61 % patients returned to FHU source
routing. The time of the patient's return home to FHU, after issuing the referral
reference ranged from 6 to 110 days. The patients return home at FHU occurred only
in Intervention, and of these patients, almost half returned to the counter reference
manually. Conclusions: The study demonstrated rate of referrals in accordance with
international standards; difficulties of access to specialized consultations, low number
of patients returns to FHU source routing, as well , that guidance and encouragement
to professionals and patients positively affect the patients return to the FHU and
counter reference source. It was believed to be feasible to implement the referral
system and counter reference electronically, allowing better communication between
professionals safely and quickly and greater integration between services.
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Citação
MORATO, Márcia Gasparini Canuto. Análise de estratégia para aplicação de sistema eletrônico na referência e contrarreferência nos serviços de saúde. 2013. 133 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2013.