Periodic gastroenterology and hepatology meetings with primary care: reasons for consultation

• Main Authors: Laura Mata-Román, Lourdes del Olmo-Martínez, Raquel Briso-Montiano, Agustina García-Pascual, Manuela Catón-Valdés, Manuel Jiménez-Rodríguez-Vila, María José Castellanos-Alonso, Lucinio Laso, Pilar Gómez-Gómez, Antonio Otero, José Ignacio Pinilla-Gimeno, Juan del Río-Hortega, Juan Pradera-Leonardo, Rosario Vallelado, Fernando Villuela-González, Elisa Ibañes-Jalón, Soledad Sañudo, Agustín Mayo, Agustín Caro-Patón, Ana Almaraz-Gómez
• Format: Article
• Language: English
• Published: Aran Ediciones 2013-10-01
• Series: Revista Espanola de Enfermedades Digestivas
• Subjects: Consultas compartidas; Intervención educativa; Gastroenterología; Hepatología; Atención primaria; Urbano; Rural; Derivaciones
• Online Access: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082013000900003&lng=en&tlng=en

Introduction: care overload, aging of population, and increased chronic diseases lead to increased referrals from primary care, which may sometimes overload the health system. Thus, different interventions have been carried out attempting to improve these aspects. Objectives: to assess the most frequent causes of consultation of general physicians, both in joint consultations and clinical sessions held jointly with specialist consultant in primary care, in the urban and rural setting, and the influence on referrals to first consultations of gastroenterology. Material and methods: a mainly training type of intervention was carried out, consisting of regular meetings in both urban and rural primary care center, to perform joint consultations and clinical sessions on patients and topics related to the specialty of gastroenterology. The intervention period (divided in two subperiods) was compared with a control period. Results: most reasons for consultation were those corresponding to lower gastrointestinal tract, followed by liver disease and upper gastrointestinal tract. Significant differences were only found in distribution of diagnoses between the two centers in joint consultations. There was a relative (percent) decrease in referrals at the global level in both subperiods, only significant in the first (51.45%), as well as in rural setting (45.24%). Conclusion: common consultations motifs were similar in urban and rural settings, with some relevance of lower gastrointestinal tract disease. Most of them can be solved at primary care, with the help of consultant specialist. There is impact on referrals to the outpatient first consultations of gastroenterology, mainly in rural setting.