[Hospital management of pediatric patients referred from primary care centers].
OBJECTIVE
To describe the hospital management of patients referred from primary care pediatricians, as well as final diagnosis and other epidemiological data.


METHODS
We performed a descriptive study of 737 patients referred to hospital for the first time by pediatricians from 13 primary care centers in the public health system. Physicians completed a 20-item report on each patient at the end of each hospital consultation. The statistical analysis included the mean and standard deviation. The Chi-square test for tendencies was performed through an R-Sigma program.


RESULTS
The mean age of the patients was 5.43 6 4.39 years. Immigration populations accounted for 14 % of patients. Fifty-three percent of the children were referred to other specialties or subspecialties, mainly cardiology (9 %), endocrinology (8 %) and pediatric surgery (5 %). The most frequent diagnoses were cardiac murmur (10 %), asthma (6.4 %) and food allergy (5.5 %). The 30 most frequent problems accounted for 71 % of all referrals. Psychosomatic problems were found in 20 % of the patients. At the end of the study, 34 % of the patients were discharged. In our study, children were followed-up for a mean of 23.9 6 20 days.


CONCLUSIONS
Approximately half the patients referred to hospital are sent to subspecialists. Training should concentrate on the 30 most commonly referred conditions. Education concerning the referral process should focus on the respective roles of physicians in the different healthcare settings, which in the hospital setting includes undergraduate and postgraduate teaching. Psychosomatic problems are frequent.
Escorihuela Esteban
R
R
Servicio de Pediatría. Fundación Jiménez Díaz. Clínica de la Concepción. Universidad Autónoma de Madrid. España. Rescorihuela@fjd.es
Barajas Sánchez
M V
MV
Domínguez Garrido
N
N
Fernández Villalba
M E
ME
D002648:Child; D005194:Family Practice; D006760:Hospitalization; D006801:Humans; D007400:Interprofessional Relations; D008511:Medicine; D010372:Pediatrics; D012017:Referral and Consultation; D013030:Spain; D013038:Specialization