Referral processes to services specialized in cardiology and endocrinology for Primary Health Care

Sérgio Vieira Bernardino Junior Cássia Regina Gotler Medeiros Camila Furtado de Souza Jordana Kich Alessandro Menna Alves Luís César de Castro About the authors


This study aimed to analyze referrals of people to cardiology and endocrinology services by doctors in Primary Health Care (PHC) in a city in Rio Grande do Sul. Cross-sectional study with questionnaires applied to 25 PHC doctors, 2 cardiologists, 2 endocrinologists and 1 regulatory doctor. Statistical analysis was performed in SPSS, with continuous variables being presented as mean or median; and categorical variables, such as absolute and relative frequencies. Among PHC doctors, 96% know, 84% use referral protocols, and 92% refer patients mainly to manage complicated diseases that require specialist evaluation. Among the specialists, 50% know the protocols, and all point out that the main reason for referrals to them occurs due to prevalent chronic conditions poorly controlled in PHC, being considered by endocrinologists as poorly indicated. The regulatory doctor assesses that most referral documents is incomplete and does not allow to verify the seriousness of the problem. It is concluded that the referral protocols are not being used in order to optimize the flow of users in the health care network, indicating the need for review of work processes, training of professionals and articulation between PHC, regulation and Specialized Care.

Chronic disease; Endocrinology; Cardiology; Primary Health Care; Health services

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