title: Organization of the referral and counter-referral system in a speech-language pathology and audiology clinic-school.
abstract: OBJECTIVE
  To analyze the effectiveness of the referral and counter-referral flow in a speech-language pathology and audiology clinic-school and to characterize the patients' profiles.
  
  
  METHODS
  Evaluation, retrospective, and prospective study, in which 503 patient records, without age restriction, were selected from a clinic-school and the following variables were analyzed: demographic information, speech and hearing diagnosis, and references. Patients were distributed into two groups according to the referrals made: internal (G1, n=341) and external (G2, n=162) to the clinic-school.
  
  
  RESULTS
  A prevalence of male subjects under 12 years of age and with diagnosis of language disorders (primary and secondary) was found. It was observed that 83% patients in G1 were recalled for evaluation and speech therapy after an average of 7 months of waiting; and from the patients in G2 that were contacted (n=101), 13.9% were summoned and are satisfied with the place indicated for therapy after an average of 4 months of waiting. From those who did not receive care, 46% sought another service, and of these, 72.5% were successful.
  
  
  CONCLUSIONS
  The data show the effectiveness and appropriateness of referrals made internally, suggesting that, when the team works together, the network operates more adequately. However, in relation to external referrals, they did not reach the proposed goals, indicating a lack of speech-language pathologists in public services and the low interest of patients in looking for other places of care.
authors.affiliation: School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Daniela Regina
authors.initials: DR
authors.lastname: Molini-Avejonas
authors.affiliation: School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Stephanie Falarara
authors.initials: SF
authors.lastname: Estevam
authors.affiliation: School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Maria Inês Vieira
authors.initials: MI
authors.lastname: Couto
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002983:Clinical Competence; D005260:Female; D034381:Hearing Loss / Q000628:therapy*; D006801:Humans; D007806:Language Disorders / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation / Q000458:organization & administration / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013070:Speech Therapy / Q000458:organization & administration / Q000706:statistics & numerical data; D013066:Speech-Language Pathology / Q000458:organization & administration / Q000706:statistics & numerical data; D014832:Voice Disorders / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult