Abstract
Rationale and Objectives: The key element for the integration of health networks is an effective system of reference and counter reference, understood as a mechanism for mutual referral of patients between different levels of service complexity. Thus, the aim of this study was to identify and analyze the reference system for the referral of patients diagnosed with tuberculosis in the city of Santa Cruz do Sul, Brazil. Methods: The study was conducted by PET Health Surveillance/Tuberculosis at the Reference Unit for Tuberculosis in the municipality (RU-TB). We conducted a descriptive survey study by reviewing the records of patients who underwent treatment for tuberculosis between the years 2007 and 2011. Data were tabulated in Excel and analyzed using SPSS 18.0. Results: A total of 239 medical records were evaluated and of these, 157 (65.7%) had no reference document or any type of referral; 53 (22.2%) had a medical prescription as a way of referral and 29 (12.1%) had the offi cial reference and counter-reference document. Of the 49 documents (20.5%) with information on the health unit that made the referral, 19 (38.8%) patients were referred to less complex units and 30 (61.2%) referred to greater complexity units. The time interval between the referral date and the reference and the start of treatment was 23 days, ranging from 0 to 296 days; the median was 4.5 days and mode was 1. There were no records related to counter-reference. Conclusion: These data show the importance of systems of reference and counter-reference for health networks, and that errors, such as failing in fi lling out these forms by health care professionals, can have an effect on health system users. KEYWORDS: Tuberculosis. Primary Health Care. Access to health services.
Highlights
TUBERCULOSE: UM ESTUDO SOBRE REFERÊNCIA EM SERVIÇOS DE SAÚDE Lia Possuelo, Anne Winck da Rosa, Heloisa Poli, Fabiane Battisiti, Maria Salette Sartori, Ana Júlia Reis, Mariélli Moraes, Andreia Rosane de Moura Valim
Em estudo realizado por Maior et al (2012) foi relatado que o tempo entre o resultado positivo de uma baciloscopia e o início do tratamento não deve ultrapassar 24-48h10
Garantir a integralidade do atendimento é responsabilidade de todos os níveis de atenção e profissionais da área da saúde, e não uma batalha individual de cada paciente, que deveria sempre ser encaminhado para o centro de saúde mais próximo de sua residência, a alguma especialidade ou a qualquer outra possibilidade existente no sistema
Summary
TUBERCULOSE: UM ESTUDO SOBRE REFERÊNCIA EM SERVIÇOS DE SAÚDE Lia Possuelo, Anne Winck da Rosa, Heloisa Poli, Fabiane Battisiti, Maria Salette Sartori, Ana Júlia Reis, Mariélli Moraes, Andreia Rosane de Moura Valim. Foi realizada uma revisão nos prontuários dos pacientes que fizeram tratamento, independente do tipo de TB, entre os anos de 2007 e 2011 (amostra de conveniência).
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