Periodic gastroenterology and hepatology meetings with primary care. Reasons for consultation.
BACKGROUND
care overload, aging of population, and increased chronic diseases lead to increased referrals from primary care, which may sometimes overload the health system. Thus, different interventions have been carried out attempting to improve these aspects.


OBJECTIVE
to assess the most frequent causes of consultation of general physicians, both in joint consultations and clinical sessions held jointly with specialist consultant in primary care, in the urban and rural setting, and the influence on referrals to first consultations of gastroenterology.


METHODS
a mainly training type of intervention was carried out, consisting of regular meetings in both urban and rural primary care center, to perform joint consultations and clinical sessions on patients and topics related to the specialty of gastroenterology. The intervention period (divided in two subperiods) was compared with a control period.


RESULTS
most reasons for consultation were those corresponding to lower gastrointestinal tract, followed by liver disease and upper gastrointestinal tract. Significant differences were only found in distribution of diagnoses between the two centers in joint consultations. There was a relative (percent) decrease in referrals at the global level in both subperiods, only significant in the first (51.45 %), as well as in rural setting (45.24 %).


CONCLUSIONS
common consultations motifs were similar in urban and rural settings, with some relevance of lower gastrointestinal tract disease. Most of them can be solved at primary care, with the help of consultant specialist. There is impact on referrals to the outpatient first consultations of gastroenterology, mainly in rural setting.
Laura
L
Mata-Román
Lourdes
L
del Olmo-Martínez
Raquel
R
Briso-Montiano
Agustina
A
García-Pascual
Manuela
M
Catón-Valdés
Manuel
M
Jiménez-Rodríguez-Vila
Maria Jose
MJ
Castellanos-Alonso
Lucinio
L
Laso
Pilar
P
Gómez-Gómez
Antonio
A
Otero
Jose Ignacio
JI
Pinilla-Gimeno
Juan
J
del-Río-Hortega
Juan
J
Pradera-Leonardo
Rosario
R
Vallelado
Fernando
F
Villuela-González
Elisa
E
Ibañes-Jalón
Soledad
S
Sañudo
Agustin
A
Mayo
Agustin
A
Caro-Patón
Ana
A
Almaraz-Gómez
D000328:Adult; D000368:Aged; D005260:Female; D005762:Gastroenterology / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data; D012424:Rural Population; D014505:Urban Population