[Coordination of general and specialized medicine. Evaluation in the Burgos area]

Abstract

Objective: To evaluate the coordination between General and Specialist Medicine, its development and the causes of breakdowns.

Design: Descriptive at two periods.

Setting: Burgos Health Area.

Participants: All the consultation request reaching Specialist Care (SC) in January 1993 and January 1995 from all the Primary Care Centres running the Mostrador programme (23); random sample of these requests in order to evaluate the proportion of return six months after the requests and to study the data found in the interconsultation notes (ICN) returned to Primary Care (PC).

Main results: The percentage of requests without and appointment being made was similar. 1.21% (1993) and 1.30% (1995); the most common cause was error/lack of data. The percentage of ICN returned to PC 6 months after the requests was also similar: 24.10% (1993) and 22.03% (1995). The most frequent reason for the failure in the circuit was that the specialist "retained" the ICNs.

Conclusions: General Medical and Specialist coordination was similar in the two periods evaluated. It was adequate for the appointment-making process, but there were break-downs in communication between doctors using the ICN. The most important reasons for these failures were identified.