Brazilian Specialists’ Perspectives on the Patient Referral Process

Juliani, Carmen Maria Casquel Monti; MacPhee, Maura; Spiri, Wilza Carla

doi:10.3390/healthcare5010004

Cited by 26 publications

(22 citation statements)

References 29 publications

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“…Without routine documentation, referral system monitoring is very challenging. Ineffective referral communications and resulting negative effects have also been reported in qualitative studies conducted in Ghana [24], Brazil [32], and Guatemala [33]. Improvements to monitoring and evaluation are critical to ongoing strengthening of the overall referral system.…”

Section: Discussionmentioning

confidence: 97%

Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

et al. 2020

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Background: A responsive and well-functioning newborn referral system is a cornerstone to the continuum of child health care; however, health system and client-related barriers negatively impact the referral system. Due to the complexity and multifaceted nature of newborn referral processes, studies on newborn referral systems have been limited. The objective of this study was to assess the barriers for effective functioning of the referral system for preterm, low birth weight, and sick newborns across the primary health care units in 3 contrasting regions of Ethiopia. Methods: A qualitative assessment using interviews with mothers of preterm, low birth weight, and sick newborns, interviews with facility leaders, and focus group discussions with health care providers was conducted in selected health facilities. Data were coded using an iteratively developed codebook and synthesized using thematic content analysis. Results: Gaps and barriers in the newborn referral system were identified in 3 areas: transport and referral communication; availability of, and adherence to newborn referral protocols; and family reluctance or refusal of newborn referral. Specifically, the most commonly noted barriers in both urban and rural settings were lack of ambulance, uncoordinated referral and return referral communications between providers and between facilities, unavailability or non-adherence to newborn referral protocols, family fear of the unknown, expectation of infant death despite referral, and patient costs related to referral. Conclusions: As the Ethiopian Federal Ministry of Health focuses on averting early child deaths, government investments in newborn referral systems and standardizing referral and return referral communication are urgently needed. A complimentary approach is to lessen referral overload at higher-level facilities through improvements in the scope and quality of services at lower health system tiers to provide basic and advanced newborn care.

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Section: Discussionmentioning

confidence: 97%

Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

et al. 2020

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“…Em 2013, houve a criação dos Núcleos Internos de Regulação (NIR), através da Política Nacional de Atenção Hospitalar, o qual contribui para melhoria contínua dos fluxos, promovendo a eficiência no uso da capacidade hospitalar, porém precisa ser respaldada pelos gestores e instituições para garantia de encaminhamento adequado, respeitando as pactuações e melhorando o treinamento dos profissionais para garantir regulação eficiente [26][27][28] .…”

Section: Discussionunclassified

Sistema de gestão para um hospital de referência

et al. 2019

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Objetivo: conhecer o perfil e demanda de urgência e emergência encaminhadas ao serviço de alta complexidade antes e após a implantação de um sistema de regulação. Metodologia: estudo retrospectivo avaliado por análise estatística de relatórios administrativos do Hospital de Clinicas de Botucatu, considerados dois períodos entre 2015 e 2018, após aprovação pelo Comitê de Ética em Pesquisa, sendo N=8921 antes e N= 10450 após implantação de sistema de regulação. Resultados: observa-se prevalência da população residente do município de Botucatu, sexo masculino com média de idade 40 anos, com entrada no serviço devido fratura, trauma, afecções cardíacas e acidente vascular cerebral com tempo médio de regulação de 1 hora, 43 minutos e 48 segundos. Conclusão: encaminhamentos classificados como urgência mínima representaram 55,1% das solicitações, 12,5% dos encaminhamentos foram contrarreferenciados. O conhecimento do fluxo e demanda contribui para a regulação do paciente.

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“…These results are useful and have the potential to impact the dietary advice given to these patients. More extensive information on missing teeth and wearing dentures provided by the Brazilian Family Health Strategy (FHS) can also afford national health teams a transdisciplinary overview . This would serve to encourage consumption of other forms of protein and to plan services that would enable elderly individuals to obtain proper dental treatment to improve their masticatory abilities.…”

Section: Discussionmentioning

confidence: 99%

Tooth loss and its relationship with protein intake by elderly Brazilians—A structural equation modelling approach

2017

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Objective: This study aimed at assessing the relationship between self-perceived tooth loss and wearing dentures, on the one hand, and the consumption of protein, on the other hand, among the elderly population of Botucatu, SP. Food consumption tends to decrease with ageing, especially protein intake, and one of the causes could be the precariousness of oral health. Several risk factors associated with deficient dietary protein intake have been identified, namely greater physical dependence, reduced caloric intake and food insecurity, but no studies have analysed whether tooth loss and prostheses interfere with protein intake.Methods: An interview was conducted among 365 elderly individuals, in which we examined oral health-related quality of life (OHRQoL) as the only latent variable, in a 24-hour nutritional assessment dietary recall repeated 3 times, conducted in person by a trained nutritionist and also performed an analysis of nutritional needs using the Nutrition Data System Research (NDSR) Program. Results:The structural equation model, performed using Stata v.14, showed that lack of teeth (standardised coefficient [SC] = 0.21, P < .001), and prosthesis use (SC = −0.21, P < .001) was associated with OHRQoL. Lack of teeth had a direct effect on the consumption of animal protein (SC = 0.08, P = .02), a strong total effect on animal protein intake (SC = 0.51, P = .04) and a medium effect on total protein intake (SC = 0.20, P = .03), adjusted for confounders (depression and medical problems). Conclusion:Tooth loss had a strong and significant total effect on animal protein intake and a medium effect on total protein intake among elderly Brazilians. K E Y W O R D Sageing, elderly, nutrient intake, quality of life

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Brazilian Specialists’ Perspectives on the Patient Referral Process

Cited by 26 publications

References 29 publications

Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

Sistema de gestão para um hospital de referência

Tooth loss and its relationship with protein intake by elderly Brazilians—A structural equation modelling approach

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