Reasons for Referral from the Primary Care Level to the Second Care Level of the Emergency Room

Abstract

Objective: to know the reasons that cause the greatest number of referrals from the primary care level to the second care level of the Emergency Room of the General Zone Hospital (gzh) No. 30 of the Mexican Institute of Social Security (imss). Methods: cross-analytical study, carried out from July to October 2015. The referral reason, etiology, prior treatment and whether it required hospitalization were analyzed. Descriptive and inferential statistics were applied; the spss v.21 program was used for statistical analysis. Results: of the 200 analyzed patients, all were referred for two or more reasons, the most common were the specialist evaluation and the diagnostic auxiliaries. Abdominal and cardiac etiologies proved to be the most common. 47.5% received prior treatment (n=95) and 52.5% required hospitalization (n=105). It was found an association between the following variables for second-level referral: age (p=0.023) and absence of prior treatment (p=0.016); an association was detected between being referred for four reasons and requiring hospitalization (p=0.024). Conclusions: the need to be evaluated by a specialist and not having some diagnostic auxiliary tests were the main reasons for referral from the Primary care level to the Second care level. A high percentage of patients required hospitalization, in addition to not receiving treatment in their reference units.