Integration among Health Are Levels: Proposed Indicator

Abstract

In order to evaluate the degree of inter-relationship between the primary health care leve1 and other levels of the health service, the use is proposed of an indicator of integration between levels with which it is possible to quantify the likelihood of receiving a response from the upper health leve1 after the doctor in primary care has requested a second opinion. To obtain the data necessary to calculate this indicator, the referrals requested and received in a health centre are studied over a period of four weeks, as well as the percentages of registration of the referrals in the case histories. The percentage of referrals over number of medical actions is 7,36 %, with an integration indicator value of 36 %. That is to say, in only 36 of every 100 referrals requested does the information requested reach its source, the doctor in primary care. In the remaining cases, the request for referral means the follow-up of that patient is lost.