title: [Ambulatory cardiologic care: comparison between patients from a referral hospital and from community health centers].
abstract: PURPOSE--Comparison between patients from a cardiology referral center and those from community health facility. PATIENTS AND METHODS--564 (5.3%) of 10667 patients from the referral center--Instituto do Coração (InCor) and 105 (58.6%) of 169 from community health facility--Centro de de Santo Amaro (CSSA), São Paulo. RESULTS--217 (35.8%) patients in InCor and 27 (25.5%) in CSSA were younger than 40 years of age. Female patients were more frequent: 316 (56%) in InCor and 70 (66.7%) in CSSA. In InCor, 317 (56.2%) patients lived in São Paulo City and in CSSA all the patients live in the surroundings. Forty-three percent of the patients sought for medical attention in InCor by themselves, without medical referral. The diagnosis of heart disease was established in 81% of the patients in InCor and in 92.5% of the patients in CSSA. Other tests (besides electrocardiogram and chest roentgenogram) were considered to be indicated in 35% of the patients from InCor. The diagnoses were: a) coronary heart disease in 92 (20.1%) cases (InCor) and in 8 (8.2%) cases (CSSA); b) valvular heart disease in 46 (10.1%) cases (InCor) and in 9 (9.2%) cases (CSSA); c) mitral valve prolapse in 31 (6.8%) cases (InCor) and in 7 (7.1%) cases (CSSA); d) congenital heart disease in 10 (2.2%) cases (InCor) and in 1 (1%) case (CSSA); e) systemic arterial hypertension in 161 (35.2%) cases (InCor) and in 55 (56.1%) cases (CSSA); f) Chagas' infection or Chagas' heart disease in 44 (9.6%) cases (InCor) and in 8 (8.2%) cases (CSSA); g) cardiac rhythm disorders in 38 (8.3%) cases (InCor) and in 8 (8.2% cases (CSSA); h) other diseases in 33 (7.2%) cases (InCor) and in 1 (1%) (CSSA); i) diseases of the aorta in 2 (0.4%) cases (InCor) and in 1 (1%) (CSSA). Medical treatment was recommended to 71.5% of the patients from the InCor and to 92.5% of the patients from CSSA. CONCLUSION--Our data suggest a degree of similarity between the groups of patients cared for in a cardiology referral center in our city in relation to a community health facility. These data may be useful in planning optimal use of referral hospitals facilities in our city.
authors.affiliation: Instituto do Coração do Hospital das Clínicas-FMUSP.
authors.forename: A T
authors.initials: AT
authors.lastname: Yamada
authors.forename: A J
authors.initials: AJ
authors.lastname: Mansur
authors.forename: P R
authors.initials: PR
authors.lastname: Chizzola
authors.forename: W
authors.initials: W
authors.lastname: Hofmann
authors.forename: G
authors.initials: G
authors.lastname: Bellotti
authors.forename: F
authors.initials: F
authors.lastname: Pileggi
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003151:Community Health Centers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
vernacular_title: Atendimento cardiológico ambulatorial: comparação entre pacientes atendidos em hospital de referência e em centro de saúde comunitário.