Derivación a las consultas de gastroenterología desde atención primaria: evaluación de dos programas

bjectives: to analyze the effect of implementing a high-resolution clinic (hrc) and an increasing resolution capacity program in primary care (ircppc) for referrals to a gastroenterology outpatient clinic from primary care and the resources used. methods: a retrospective and observational study based on a review of referral sheets and databases was performed. we analyzed the number and reason for referrals, delay times and resource consumption in two periods: before (first 4 months of 2007) and after (first 4 months of 2009) the launch of the ircppc and hrc. results: in the first and second periods, 881 and 1076 patients, respectively, referred from primary health care were evaluated in the gastroenterology clinic, with a decrease in the delay time in the second period (80.8±64.34 days vs 36.1±29.12 days, p<0.001). the most frequent reasons for referral were dyspepsia (27.7%), high-risk of colorectal cancer (17.1%), disturbance of bowel rhythm (18.2%), abdominal pain (16%), and gastroesophageal reflux (11.2%), with no differences between the two periods. although delay times until the first visit (10.8±9.03 days vs 42.8±28.67 days, p<0.001) and until discharge (39.6±80.65 days vs 128.6±135.34 days, p<0.001) were lower in referrals to the hrc, the number of visits (3.6±2.20 vs 3.2±1.95, p=0.015) and the cost of referrals (592.7±421.50 € vs 486.0±309.66 €, p<0.001) was higher. conclusions: in the study period the number of referrals increased, while the delay time decreased. although the hrc reduces delay times, it is associated with an increase in health resource use.