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Elective pediatric surgery: profile description of children and late referral identification
Carolina Talini1, Ariana Rodrigues DA Silva Carvalho1, Claudia Silveira Viera1
1- Universidade Estadual do Oeste do Paraná, Programa de Pós-graduação em Biociências & Saúde - Cascavel - PR - Brasil.
Insights
Many pediatric patients face delayed surgical care, with over a quarter experiencing late referrals. This study highlights the need for improved access to timely pediatric surgery evaluations and interventions in western Paraná.
Area of Science:
- Pediatric Surgery
- Healthcare Access
- Public Health
Background:
- Primary care services frequently refer pediatric patients for surgical evaluation.
- Timely access to specialized pediatric surgical evaluation and intervention is a significant challenge.
Purpose of the Study:
- To characterize pediatric patients undergoing elective surgery in western Paraná (2018-2020).
- To identify patients experiencing delayed referrals for surgical evaluation and treatment.
Main Methods:
- Descriptive, cross-sectional, and retrospective study.
- Analysis of electronic medical records for sociodemographic data, underlying conditions, referral details, specialist assessment, and surgical procedures.
- Inclusion of 289 pediatric patients from 410 who underwent elective surgery.
Main Results:
- The study predominantly included male patients (72.3%).
- Inguinal hernia was the most common pathology (39.1%).
- A significant proportion (26.6%) of patients were referred late for surgical procedures, with a mean interval of 4.98 months from primary care referral to surgery.
Conclusions:
- Understanding patient profiles and referral delays is crucial for improving pediatric surgical care systems.
- Findings provide insights for developing targeted improvement strategies in western Paraná and similar regions in Brazil.
- Addressing referral delays can enhance the efficiency and timeliness of pediatric surgical interventions.
Abstract:
Pediatric surgery receives great demand for referrals from primary care services in order to evaluate the need for surgical intervention. However access to this specialized evaluation and in intervention does not always occur at the appropriate time. This study aims to characterize the profile of pediatric patients electively operated in the western Paraná state region, between 2018 and 2020, and identify those who were lately referred to surgical evaluation. This is a descriptive, cross-sectional and retrospective study through the review of electronic medical records. The variables evaluated were sociodemographic data, information on underlying diseases, referral data, specialist assessment and surgical procedure. During this period, 410 patients underwent an elective surgical procedure, of which 289 were included in the research. The sample was predominantly male (72.3%) with a mean age of 57.9 months at the surgeons assessment and 59 months at the date of surgery. Most of the patients came from primary care (75%) and the most common pathology was inguinal hernia (39.1%). The mean time interval between referral through primary care and surgery was 4.98 months, and between the surgeons assessment and surgery was 1.21 months. Of the total sample, 77 (26.6%) patients were identified as being referred late for the surgical procedure. Knowing the profile of patients and the problems experienced in this region in relation to the care provided in pediatric surgery provides subsidies to propose improvement strategies not only for the health system in this location, but for several inner regions of Brazil in a similar situation.
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