ONLINE NATIONAL PRIMARY CARE REFERRAL SYSTEM EVALUATION: HOW EFFECTIVE IS IT?

Introduction and objectives Our purpose is to evaluate an online national referral system articulating primary healthcare and hospital care, using information systems. The family doctor refers patients to be sorted by a specialist hospital doctor and scheduled. Our study aims to identify the strengths and frailties of the referrals, as a tool to improve communication and access. Methods During a 2 months period we have evaluated all the referrals to Orthopedics outpatient clinic in western Lisbon: registered patients by demographic characteristics, type and quality of the referral, sorting and scheduling. Results and conclusions 312 referrals were registered form 16 health centers to one hospital. Waiting time was: 2,8 days until sorting, 47,5 days until scheduling. 20 patients had been to orthopedics clinic before. 8 patients had been to the emergency for the referral cause. 8 were referred for having missed the previous appointment. 8,3% were referred as emergent: cause of priority not apparent in 14 cases, 7 post-traumatic. 5,1% were refused: 7 sent to the emergency to be scheduled directly (6 fractures , 1 tumor), 3 redirected to other clinics. 67% needed 3 sub-specialties: 39% knee, 14% foot, 13,8% shoulder. Overall referrals were adequate. There is room for improvement in the quality of information. There is a need to adjust expectations relating to hospital’s time to respond. Knowing the type of demand allows the hospital to implement measures to better provide for its population. Creating a “dialogue box” in the informatics system may be a useful communication tool.