Adequação dos encaminhamentos de gestações de alto-risco na Rede Básica de Atenção à Saúde de Porto Alegre, Rio Grande do Sul, Brasil

Abstract

Objectives: to determine the most prevailing causes and referral adequacy of prenatal patients from Porto Alegre, Rio Grande do Sul, metropolitan and rural areas. Methods: 821 referrals to the High Risk Pregnancy Clinic of the Hospital Fêmina of the Grupo Hospitalar Conceição, from July 1997 to July 2000 were reviewed. Referrals were classified as: confirmed, added, modified, not conclusive or not confirmed. Results: 201 (24.5%) were considered inadequate. Most common causes for referring pre-natal patients were arterial hypertension and diabetes. Inadequacy was more frequent in pregnant women residing out of the metropolitan area and among the younger ones. The most frequent inadequacy causes were referrals based on bureaucratic reasons and lack of information. Kappa rates among diagnosis performed by primary care doctors and referral services were respectively 0.28 and 0.41. Conclusions: diagnosis agreement was determined to be low. There is a need for training to improve basic healthcare services specially focused on doctors working outside the metropolitan area.