Evaluation of reference and counter-reference in the Family Health Program at the metropolitan region of Rio de Janeiro (RJ, Brazil)

• Published in: Ciência & saude coletiva Vol. 15 Suppl 3; pp. 3579 - 3586
• Main Authors: Serra, Carlos Gonçalves, Rodrigues, Paulo Henrique de Almeida
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01.11.2010
• Subjects: Brazil; Family Health; Government Programs; Humans; Referral and Consultation - standards; Referral and Consultation - statistics & numerical data; Urban Population; Brazil
• ISSN: 1678-4561
• DOI: 10.1590/S1413-81232010000900033

This article presents the results of research on the functioning of the reference and counter-reference system in support of activities carried out by the Brazilian Family Health Program in the cities of Duque de Caxias (RJ) and Rio de Janeiro. The research had as premise that the resolution capacity of the Brazilian Family Health Program depends on the support of specialist's medical appointments and diagnosis test offered by health care unities of the secondary level, and depends upon reference and counter-reference information. The research's results may be summarized as: (1) limited offer of specialized services in the secondary level of the health care system; (2) nonexistence or failure of counter-reference information; (3) deficient organization of regulation activities; (4) insufficient utilization of clinical guidelines for patient referrals; (5) precariousness of information and communication systems; (6) high level of political influence in the management of health care services; and (7) different denominations and great diversity of types of service offered by secondary health care unities.