Quality of care: reference and counter reference from family physicians and rheumatologists' perspectives in São Carlos, Brazil

• Grant number: 12/05038-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2012
• End date: December 31, 2013
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Mirhelen Mendes de Abreu
• Grantee: Thiago Dias Baumgratz
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

The failure of the process of reference and counter reference of the health system has implicated duplication of service, resulting in underutilization of specialized care. Objectives: Delineate and describe family physicians' point of view when facing cases of rheumatic diseases. Identify barriers in the reference and counter reference. Methodology: This is a pilot study, transversally designed, with family physicians and rheumatologists in the city of São Carlos, São Paulo, Brazil. The methodological steps are: (1) development and preparation of clinical scenarios that simulate and address different levels of clinical severity, (2) application of these scenarios in the population of family physicians and specialists, (3) validation of the study scenarios. The same scenarios are presented to two groups of physicians, which should indicate their point of view for the management of the clinical conditions presented. Finally, multiple-choice questions that address potential factors that lead to barriers in the process of reference and counter reference will be asked. Expected Results: The constructed scenarios may help identify potential barriers to the effectiveness of the reference process and counter reference. Potential gains from the study: To enable the development of new studies to understand the barriers and powers of communications between levels of care, contributing to the effectiveness of the strategy of reference and counter reference. Key words: quality of care; rheumatology care; reference and counter reference; communication, health assessment technology.(AU)