Unified health system and outpatient clinic demand

the patients of the university hospital of the faculty of medicine of Ribeirão Preto - USP

Abstract

Objective - To study the socioeconomic aspects and the morbidity of patients seen at the outpatient clinics of UHFMRP-USP.

Material and Methods – A total of 308 patients were interviewed after being selected by a probabilistic sampling process. Morbidity was described on the basis of the respective groups of major diagnoses (IDC-1975). Results – Most patients belonged to low income occupational categories; 70% were economically active; 40.7% were from Ribeirão Preto (37.1% appered without referral); 27.2% from ERSA 50 region (18.1% without referral); 21.6% from the remaining ERSA (24.2% without referral); 10.5% from other states (15.6%without referral). Medical screening corresponded to 6% of the daily visits (77.7% these were dismissed); the visits schedule at the specialized outpatient clinics represented 75.3% of the total, and 18.8% of the visits were due to other procedures. With respect to morbidity, here was a higher search for Pneumology assistence (Diseases of the Respiratory Tract) among the patients without referral, and undiagnosed diseases or diseases to be investigated among referred patients; the highest demand was due to Diseases of the Nervous System, Neoplasm,Supplementary Diagnoses (V01 to V08) and Diseases of the Genitourinary Tract. Conclusions – In practice, visits at the outpatients clinic with a referral form do not satisfy the assumptions of hirarchization; a considerable number of patients could have been seen in the respective basic units, suggesting na exclusion of the primary and secundary levels, whose causes were not determined; the greatest demand was on part of Ribeirão Preto residents and the procedures most often requested were those of high cost and/or involving prolonged treatments.