[Examinations and referrals at a health center: a study of associated factors]

To determine the profile of the use of physical examination, further tests and referrals; and the impact which socio-family and behavioural factors, questions connected with patients' morbidity and other variables in health service use, have on these resources.

Descriptive crossover study.

Urban health centre.

719 attendances of patients seen over a two and a half month period in two general medical clinics at the health centre were analysed. A questionnaire on health care was presented by the doctor to the patient at the end of the visit and also covered the activities and resources used during the visit.

A multivariant analysis identified the factors which best explained variability in the frequency of physical examination as symptoms and, in particular, the type of consultation. None of the factors studied affected the use of analysis, radiology or referral to specialists.

Symptoms and, in particular, the type of consultation are the factors which affect the use of physical examination. The scant relevance of other factors analysed and the comparison of our findings with other studies published suggest that the use of further examinations and referrals depend basically on other variables, such as those connected to the availability of resources and accessibility to them.