[Urological attendance in the Integral Health Center "Alto Palancia": model of primary-specialized integration and unique consultation].
OBJECTIVE
The progressive increase in the demand of urological attendance demands to establish new welfare models that avoid the saturation of consultations and improve the quality in the attention to the user. The objective of this work is to analyze the improvement of the welfare activity developed in Integral the Sanitary Center Alto Palancia, after the restoration of new welfare models based on integration between Attention Primary and Specialized and the putting in practice of the denominated Unique Consultation.


METHODS
We analyzed the characteristics of the Center, functions and activity of the specialty developed during year 2002. We described to the application of the model of Unique Consultation and the elements of integration with Primary Attention. We analyzed the improvement of the activity through indicators, that we compared with preceding years. In order to determine the degree of satisfaction of the users we made a survey of opinion of patients and/or taken care of relatives in the Center under the new welfare models. Finally we analyzed the advantages that the applied process presents for the patient and the own sanitary institution.


RESULTS
42% of patients have been taken care of by means of the model of Unique Consultation, being the predominant pathology the HBP in the man and the ITUs in the woman. The time of delay for first visit has been reduced from 49 days in single December 2001 to 3 in December 2002. Single 7.7% of patients discharged from the hospital for pursuit by Primary Attention have been sent again to the specialist. The time that the urólogo dedicates to consultations has reduced in a 29%, being this time dedicated to the accomplishment smaller surgery and final reconnaissances (echography, urodynamic studies and others). The opinion survey has shown a satisfaction of the user very elevated.


CONCLUSIONS
The model of Integral Attention Primary-Specialized and the putting in practice of Unique Consultation applicable to the specialty of Urology, increasing the quality perceived by the user and with evident advantages for the Sanitary Organization.
Queipo Zaragozá
J A
JA
Servicio de Urología, Hospital de Sagunto, Valencia. queipo@pulso.com
Moral Baltuille
A
A
Beltrán Meseguer
J F
JF
Marco Aznar
A
A
Borrell Palanca
A
A
Chicote Pérez
F
F
Armañanzas Villena
E
E
Pastor Sempere
F
F
D006801:Humans; D017146:Models, Organizational; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation; D013030:Spain; D014570:Urologic Diseases / Q000628:therapy; D014573:Urology Department, Hospital / Q000458:organization & administration*