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Norma Sartori, Sabina De Rosis, Chiara Seghieri, Giorgio Visentin

Continuity of care and communication among general practitioners, specialists and patients in Italy. Norma Sartori, Sabina De Rosis, Chiara Seghieri, Giorgio Visentin. PATIENT’S PERSPECTIVE. Referrals rate GPs vs specialists communications Specialists vs GPs communications

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Norma Sartori, Sabina De Rosis, Chiara Seghieri, Giorgio Visentin

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  1. Continuity of care and communication among general practitioners, specialists and patients in Italy Norma Sartori, Sabina De Rosis, Chiara Seghieri, Giorgio Visentin EFPC 2014, 1st September

  2. PATIENT’S PERSPECTIVE • Referrals rate • GPs vs specialists communications • Specialists vs GPs communications • Specialist’s choice • Barriers to referral EFPC 2014, 1st September

  3. PATIENTS PERSPECTIVE • Patients mostly see a specialist 1 or 2 times a year • 48% of their GPs inform the spacialist about the diagnosis • 83% of specialists send back an answer to the GPs • GPs don’t decide who is the specialist in 54% of cases • 80% of patients have an easy access to specialist EFPC 2014, 1st September

  4. DOCTORS PERSPECTIVE • Setting • Who decide the referral /causes of referral • GPs internal relationship • Meeting with other health professional • Counselling to others professionals • Letter to specialist • Report from specialist • Time for discharge letter EFPC 2014, 1st September

  5. Setting • 50 % of practices shared with others GPs • A minority with nurses • No one with specialists • Only 28 GPs don’t have easy access to laboratory • 30% don’t have easy access to Radiodiagnostic • 5% are more than 20 km from hospital EFPC 2014, 1st September

  6. Referral characteristic EFPC 2014, 1st September

  7. COMMUNICATION BETWEEN GPS AND SPECIALISTS • Shared decision with patients • 68% of GPS don’t send a letter to the specialist • 54% of specialist don’t write an answer to the GPS • One third of discharge letters are delayed more than 5 days (14/220 never arrived) EFPC 2014, 1st September

  8. Interprofessional meetings EFPC 2014, 1st September

  9. Counselling from specialists • GPs usually exchange opinions mostly with psychiatrists, radiologists and neurologist

  10. Conclusions Referral is not (only) a matter of number It is often a shared decision Communication GPs <-> Specialists is poor Meeting only among GPs Teamwork is poor (only halfof GPs work in group, but with few nurses and rare meetings) EFPC 2014, 1st September

  11. Conclusioni • Assenza di un team di medici che lavorano in collaborazione per gestire il paziente • Solo metà dei medici condividono lo studio con colleghi • Solo 35 medici hanno un infermiere • Solo 15 medici hanno nello studio un infermiere territoriale • Rarissimi incontri strutturati con infermieri domiciliari e assistenti sociali • Assenza nel questionario di domande volte a indagare il lavoro in team EFPC 2014, 1st September

  12. Conclusions IT is a starting point to improve the quality of Primary Care. If you want to reach common goal you need a stronger relationship among the health workers in order to motivate them for a common project A successful teamwork need a complex educational process in order to overcome the competition and facilitate collaboration EFPC 2014, 1st September

  13. Thank you for your attention EFPC 2014, 1st September

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