Impacto da formação em medicina de família e comunidade nos encaminhamentos para a atenção secundária no município de Belo Horizonte

Abstract

Primary Health Care (PHC) is the main scenario in which physicians specializing in Family Medicine (FM) work. In Brazil, the PHC model adopted, the Family Health Strategy (FHS), still allows doctors without specific training in FM (also called generalists), or doctors who specialized in other areas, to work at this level of care. In the city of Belo Horizonte, Brazil, the health care network of the Unified Health System (Sistema Único de Saúde - SUS) coexists with a high number of referrals from PHC to secondary care. Therefore, it is a great challenge for primary care to seek professionals who can avoid unnecessary referrals. The aim of this study was to analyze the impact of FM training and qualifications on the proportions of referrals to secondary care performed by PHC physicians in the selected city. A total of 965 doctors who work or worked in the FHS in the city, from 2013 to 2020, were selected and divided into two groups: doctors with training or degree in FM and doctors without this training/title. An analysis was made of the proportions of referrals by professionals in these groups and an assessment of the impact of training/title in FM on referrals to secondary care was carried out. It was concluded that physicians with training or qualifications in FM refer patients in a smaller proportion than physicians without the specialty, in the evaluated specialties, except for ophthalmology and pulmonology.