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Brazilian Specialists’ Perspectives on the Patient Referral Process

Since 1988, healthcare has been considered a citizen’s right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world’s fifth largest population. The coordination of effective communications between p...

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Autores principales: Juliani, Carmen, MacPhee, Maura, Spiri, Wilza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371910/
https://www.ncbi.nlm.nih.gov/pubmed/28146046
http://dx.doi.org/10.3390/healthcare5010004
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author Juliani, Carmen
MacPhee, Maura
Spiri, Wilza
author_facet Juliani, Carmen
MacPhee, Maura
Spiri, Wilza
author_sort Juliani, Carmen
collection PubMed
description Since 1988, healthcare has been considered a citizen’s right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world’s fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo. This paper reports specialists’ perspectives of the referral process. This was a phenomenological study that employed a qualitative research method with three components (description, reduction and comprehension). We conducted focus groups with 54 hospital residents from different specialties (surgery, medicine, obstetrics/gynecology, pediatrics) from July to October 2014. The main results showed lack of an adequate referral-return referral process resulting in treatment delays and inappropriate use of emergency services. Communications were impeded by lack of integrated, computerized booking and standardized referral-return referral processes; underlying lack of trust in primary care physicians; and patients’ inappropriate use of healthcare services. Although computerized systems will facilitate communications between primary and specialty care, other strategies are needed to promote collaboration between services, and ensure appropriate utilization of them.
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spelling pubmed-53719102017-04-10 Brazilian Specialists’ Perspectives on the Patient Referral Process Juliani, Carmen MacPhee, Maura Spiri, Wilza Healthcare (Basel) Article Since 1988, healthcare has been considered a citizen’s right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world’s fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo. This paper reports specialists’ perspectives of the referral process. This was a phenomenological study that employed a qualitative research method with three components (description, reduction and comprehension). We conducted focus groups with 54 hospital residents from different specialties (surgery, medicine, obstetrics/gynecology, pediatrics) from July to October 2014. The main results showed lack of an adequate referral-return referral process resulting in treatment delays and inappropriate use of emergency services. Communications were impeded by lack of integrated, computerized booking and standardized referral-return referral processes; underlying lack of trust in primary care physicians; and patients’ inappropriate use of healthcare services. Although computerized systems will facilitate communications between primary and specialty care, other strategies are needed to promote collaboration between services, and ensure appropriate utilization of them. MDPI 2017-01-29 /pmc/articles/PMC5371910/ /pubmed/28146046 http://dx.doi.org/10.3390/healthcare5010004 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Juliani, Carmen
MacPhee, Maura
Spiri, Wilza
Brazilian Specialists’ Perspectives on the Patient Referral Process
title Brazilian Specialists’ Perspectives on the Patient Referral Process
title_full Brazilian Specialists’ Perspectives on the Patient Referral Process
title_fullStr Brazilian Specialists’ Perspectives on the Patient Referral Process
title_full_unstemmed Brazilian Specialists’ Perspectives on the Patient Referral Process
title_short Brazilian Specialists’ Perspectives on the Patient Referral Process
title_sort brazilian specialists’ perspectives on the patient referral process
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371910/
https://www.ncbi.nlm.nih.gov/pubmed/28146046
http://dx.doi.org/10.3390/healthcare5010004
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