Impact of restriction on cardiovascular complementary exams in Primary Health Care
evaluation of referrals to Cardiology
DOI:
https://doi.org/10.5712/rbmfc19(46)4208Keywords:
Primary Health Care, Cardiovascular diseases, Diagnostic techniques, cardiovascular, Echocardiography.Abstract
Introduction: Primary care physicians in Porto Alegreare not allowed to request complementary exams, such as echocardiography, to investigate prevalent cardiovascular diseases (CVD) within the scope of Primary Health Care (PHC). Despite many CVD diagnoses being primarily clinical, diagnostic complementary exams facilitate better staging and monitoring. Objective: To quantify and evaluate referrals made to the Cardiology specialty for diagnostic investigation of CVD, with an emphasis on referrals due to heart failure (HF). Methods: A descriptive study reviewed 305 referrals from 9 health care units (HCU) in Porto Alegreto the Cardiology specialty from 03/01/2022 to 08/31/2022. Demographic characteristics, reason for, and status of the referrals were collected, especially for suspected HF. Results: Of the 305 referrals analyzed, 74 patients (24.2%) were referred for complementary exams (echocardiography, myocardial scintigraphy, Holter, among others). Among the patients referred due to HF, 26 (44.8%) were referred for investigation and diagnostic classification due to the unavailability of the exam, and none of these patients would have another indication to remain in secondary care at the time of referral (which represents 8.5% of the total referrals for the Cardiology specialty). Most of the referrals for suspected HF were in accordance with the current referral protocols. Conclusions: The restriction on requesting exams in PHC in Porto Alegre, especially echocardiography, hampers the diagnosis and treatment of HF in PHC and increases the demand for the Cardiology services. This study highlights the need to review the policies restricting the request for exams in PHC in Porto Alegre, especially for conditions sensitive to this level of care.
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