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General surgery referral´s outcomes and solution time

Angélica Castro-Ríos1, Armando Nevarez-Sida, María Enriqueta Baridó-Murguía

  • 1Instituto Mexicano del Seguro Social, Hospital de Pediatría, Unidad de Investigación en Epidemiología Clínica. Ciudad de México, México

Revista Medica Del Instituto Mexicano Del Seguro Social
|January 30, 2020
PubMed
Summary
This summary is machine-generated.

Two new indicators effectively measure the coordination between primary and secondary healthcare levels. Most surgical referrals were resolved, demonstrating good continuity of care.

Keywords:
Continuity of Patient CareHealth Care LevelsTransitional CareGeneral Surgery

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Area of Science:

  • Healthcare Management
  • Public Health
  • Surgical Services

Background:

  • Existing tools for continuity of care assessment lack focus on inter-level coordination outcomes.
  • There is a need for indicators that specifically describe the results of healthcare coordination between primary and secondary levels.

Purpose of the Study:

  • To introduce and evaluate two novel indicators for assessing the complete circuit of care: primary level-secondary level-primary level.
  • To summarize the outcomes and efficiency of patient referrals between healthcare tiers.

Main Methods:

  • An observational prospective cohort study with a one-year follow-up was conducted.
  • A random sample of general surgery referrals from a family medicine unit was analyzed.
  • Two indicators were developed: referral outcome (resolved, withdrawn, not resolved) and time to resolution (median calendar days).

Main Results:

  • 84.8% of surgical referrals were resolved, with a median resolution time of 72 days.
  • 14.1% of patients declined surgery, and 1% of referrals were not resolved.
  • No statistically significant differences in resolution or time were found based on patient or physician characteristics.

Conclusions:

  • The developed indicators provide a summary of the primary-secondary-primary care circuit outcomes.
  • Overall surgical problem resolution time aligns with previous studies, though specific diagnoses show variations.
  • High resolution rates were observed for high-risk diagnoses, suggesting effective care coordination for critical conditions.