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| Fältnamn | Indikatorer | Metadata |
|---|---|---|
| 000 | 03213naa a2200301 4500 | |
| 001 | oai:prod.swepub.kib.ki.se:149289242 | |
| 003 | SwePub | |
| 008 | 240701s2022 | |||||||||||000 ||eng| | |
| 024 | 7 | a http://kipublications.ki.se/Default.aspx?queryparsed=id:1492892422 URI |
| 024 | 7 | a https://doi.org/10.1136/bmjopen-2021-0515152 DOI |
| 040 | a (SwePub)ki | |
| 041 | a engb eng | |
| 042 | 9 SwePub | |
| 072 | 7 | a ref2 swepub-contenttype |
| 072 | 7 | a art2 swepub-publicationtype |
| 100 | 1 | a Jantsch, AG4 aut |
| 245 | 1 0 | a Residency training in family medicine and its impact on coordination and continuity of care: an analysis of referrals to secondary care in Rio de Janeiro |
| 264 | c 2022-02-15 | |
| 264 | 1 | b BMJ,c 2022 |
| 520 | a To measure the effect that residency training in family medicine (RTFM) has on continuity and coordination of care.DesignObservational cohort study using electronic health records.SettingRio de Janeiro, Brazil, public primary care system.Participants504 940 patients, 633 generalists (physicians without RTFM) and 204 family physicians (FP—doctors with 2 years of RTFM) from one health district between January 2015 and December 2018.InterventionTwo years of RTFM.Main outcome measuresRelative risks of patients being referred to secondary care for outpatient consultations and diagnostics tests; and having a follow-up medical consultation in primary care within 3 and 6 months after being referred.ResultsWe examined 2 414 508 medical consultations and 284 754 referrals to secondary care. FPs were less likely to request ambulatory care services (including surgical specialties), but were more likely to request ophthalmology, physiotherapy, rehabilitationand surgical evaluations for their patients. Patients referred to secondary care by FPs were more likely to have a follow-up visit in primary care for almost every service requested. If all medical consultations were performed by FPs, a 37.6% (95% CI 32.4% to 42.4%) increased demand for rehabilitation services would be noticed. Oppositely, 1532 (95% CI 1458 to 1602) fewer requests for dermatology would happen every year.ConclusionsRTFM improves coordination and continuity of care by making FPs more competent to retain those health conditions that can be properly managed in primary care and making FPs more competent to detect health conditions that require specific biomedical technologies and skills, increasing the demand for those services. Besides, it increases the chances of patients having follow-up visits in primary care. Policy-makers in low-income and middle-income countries must consider investing in RTFM to make primary care systems more comprehensive, with better coordination and continuity of care. | |
| 700 | 1 | a Burstrom, Bu Karolinska Institutet4 aut |
| 700 | 1 | a Nilsson, GHu Karolinska Institutet4 aut |
| 700 | 1 | a de Leon, AP4 aut |
| 710 | 2 | a Karolinska Institutet4 org |
| 773 | 0 | t BMJ opend : BMJg 12:2, s. e051515-q 12:2<e051515-x 2044-6055 |
| 856 | 4 | u https://bmjopen.bmj.com/content/bmjopen/12/2/e051515.full.pdf |
| 856 | 4 8 | u http://kipublications.ki.se/Default.aspx?queryparsed=id:149289242 |
| 856 | 4 8 | u https://doi.org/10.1136/bmjopen-2021-051515 |
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