Decentralizing referral prioritization to general practitioners at the primary care level: A qualitative case study based on the Grounded Theory
BACKGROUND: Patient referral prioritizations is an essential process in coordinating healthcare delivery, since it organizes the waiting lists according to priorities and availability of resources. OBJECTIVE: This study aims to highlight the consequences of decentralizing ambulatory patient referral...
Gespeichert in:
Veröffentlicht in: | Work (Reading, Mass.) Mass.), 2024-01, Vol.77 (4), p.1189-1203 |
---|---|
Hauptverfasser: | , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 1203 |
---|---|
container_issue | 4 |
container_start_page | 1189 |
container_title | Work (Reading, Mass.) |
container_volume | 77 |
creator | Jatobá, Alessandro Bellas, Hugo Arcuri, Rodrigo Sobral, André Luiz Avelino Bulhões, Bárbara Vianna, Jaqueline de Castro Nunes, Paula d’Avila, Adriana Lourenço de Carvalho, Paulo Victor Rodrigues |
description | BACKGROUND:
Patient referral prioritizations is an essential process in coordinating healthcare delivery, since it organizes the waiting lists according to priorities and availability of resources.
OBJECTIVE:
This study aims to highlight the consequences of decentralizing ambulatory patient referrals to general practitioners that work as family physicians in primary care clinics.
METHODS:
A qualitative case study was carried out in the municipality of Rio de Janeiro. The ten health regions of Rio de Janeiro were visited during fieldwork, totalizing 35 hours of semi-structured interviews and approximately 70 hours of analysis based on the Grounded Theory.
RESULTS:
The findings of this study show that the obstacles to adequate referrals are beyond the management of vacancies, ranging from the standardization of prioritization criteria to ensuring the proper employment of referral protocols in diverse locations assisted by overloaded health workers with different backgrounds and perceptions. Efforts in decentralizing patient referral to primary care still face the growing dilemmas and challenges of expanding the coverage of health services while putting pressure on risk assessment, as well as sustaining the autonomy of physicians’ work while respecting the eligibility when ordering waiting lists.
CONCLUSION:
A major strength of this work is on the method to organize and aggregate qualitative data using visual representations. Limitations concerning the reach of fieldwork in vulnerable and hardly accessible areas were overcame using snowball sampling techniques, making more participants accessible. |
doi_str_mv | 10.3233/WOR-230228 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2892011907</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.3233_WOR-230228</sage_id><sourcerecordid>2892011907</sourcerecordid><originalsourceid>FETCH-LOGICAL-c306t-77ff8ded191c897edccdd99dfb870f1b33d2dcee9ff5d88f6da80246912d7f483</originalsourceid><addsrcrecordid>eNptkdtqGzEQhkVpaY43eYAg6EVCYFsdvJaUu5BTCwZDScjlIksjZ8N6lUjagPMUfeSOWaeF0quZ0Xzza5ifkCPOvkoh5beH-c9KSCaE_kB2uVZ1ZYRiHzFnNa-M5vUO2cv5iTFkmPlMdqQymtWG75JfV-CgL8l27VvbL2mCAAkr-pzamNrSvtnSxp6WSJfQw9ixrrSbV0iZ2kLLI2zwlU1r6mwC2sErdOf0gr4MqFtQ4RWwk4HmMvg1XWDq6UYVJ29THHqP9d0jxLQ-IJ-C7TIcbuM-ub-5vrv8Xs3mtz8uL2aVk2xaKqVC0DjFDXfaKPDOeW-MDwutWOALKb3wDsCEUHutw9RbzcRkarjwKky03Ceno-5zii8D5NKs2uyg62wPcciN0EYwzg1TiH75B32KQ-pxu0ayujZKqYlE6mykXIo54x2b7U0azpqNTw361Iw-IXy8lRwWK_B_0HdjEDgZgWyX8Pe__0j9BqJDnSo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3055977743</pqid></control><display><type>article</type><title>Decentralizing referral prioritization to general practitioners at the primary care level: A qualitative case study based on the Grounded Theory</title><source>Business Source Complete</source><creator>Jatobá, Alessandro ; Bellas, Hugo ; Arcuri, Rodrigo ; Sobral, André Luiz Avelino ; Bulhões, Bárbara ; Vianna, Jaqueline ; de Castro Nunes, Paula ; d’Avila, Adriana Lourenço ; de Carvalho, Paulo Victor Rodrigues</creator><creatorcontrib>Jatobá, Alessandro ; Bellas, Hugo ; Arcuri, Rodrigo ; Sobral, André Luiz Avelino ; Bulhões, Bárbara ; Vianna, Jaqueline ; de Castro Nunes, Paula ; d’Avila, Adriana Lourenço ; de Carvalho, Paulo Victor Rodrigues</creatorcontrib><description>BACKGROUND:
Patient referral prioritizations is an essential process in coordinating healthcare delivery, since it organizes the waiting lists according to priorities and availability of resources.
OBJECTIVE:
This study aims to highlight the consequences of decentralizing ambulatory patient referrals to general practitioners that work as family physicians in primary care clinics.
METHODS:
A qualitative case study was carried out in the municipality of Rio de Janeiro. The ten health regions of Rio de Janeiro were visited during fieldwork, totalizing 35 hours of semi-structured interviews and approximately 70 hours of analysis based on the Grounded Theory.
RESULTS:
The findings of this study show that the obstacles to adequate referrals are beyond the management of vacancies, ranging from the standardization of prioritization criteria to ensuring the proper employment of referral protocols in diverse locations assisted by overloaded health workers with different backgrounds and perceptions. Efforts in decentralizing patient referral to primary care still face the growing dilemmas and challenges of expanding the coverage of health services while putting pressure on risk assessment, as well as sustaining the autonomy of physicians’ work while respecting the eligibility when ordering waiting lists.
CONCLUSION:
A major strength of this work is on the method to organize and aggregate qualitative data using visual representations. Limitations concerning the reach of fieldwork in vulnerable and hardly accessible areas were overcame using snowball sampling techniques, making more participants accessible.</description><identifier>ISSN: 1051-9815</identifier><identifier>EISSN: 1875-9270</identifier><identifier>DOI: 10.3233/WOR-230228</identifier><identifier>PMID: 37980591</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Accessibility ; Case studies ; Family physicians ; Field study ; Fieldwork ; Grounded theory ; Health care ; Health services ; Medical personnel ; Medical referrals ; Physicians ; Primary care ; Qualitative analysis ; Resource availability ; Risk assessment ; Standardization</subject><ispartof>Work (Reading, Mass.), 2024-01, Vol.77 (4), p.1189-1203</ispartof><rights>2024 – IOS Press. All rights reserved</rights><rights>Copyright IOS Press BV 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c306t-77ff8ded191c897edccdd99dfb870f1b33d2dcee9ff5d88f6da80246912d7f483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37980591$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jatobá, Alessandro</creatorcontrib><creatorcontrib>Bellas, Hugo</creatorcontrib><creatorcontrib>Arcuri, Rodrigo</creatorcontrib><creatorcontrib>Sobral, André Luiz Avelino</creatorcontrib><creatorcontrib>Bulhões, Bárbara</creatorcontrib><creatorcontrib>Vianna, Jaqueline</creatorcontrib><creatorcontrib>de Castro Nunes, Paula</creatorcontrib><creatorcontrib>d’Avila, Adriana Lourenço</creatorcontrib><creatorcontrib>de Carvalho, Paulo Victor Rodrigues</creatorcontrib><title>Decentralizing referral prioritization to general practitioners at the primary care level: A qualitative case study based on the Grounded Theory</title><title>Work (Reading, Mass.)</title><addtitle>Work</addtitle><description>BACKGROUND:
Patient referral prioritizations is an essential process in coordinating healthcare delivery, since it organizes the waiting lists according to priorities and availability of resources.
OBJECTIVE:
This study aims to highlight the consequences of decentralizing ambulatory patient referrals to general practitioners that work as family physicians in primary care clinics.
METHODS:
A qualitative case study was carried out in the municipality of Rio de Janeiro. The ten health regions of Rio de Janeiro were visited during fieldwork, totalizing 35 hours of semi-structured interviews and approximately 70 hours of analysis based on the Grounded Theory.
RESULTS:
The findings of this study show that the obstacles to adequate referrals are beyond the management of vacancies, ranging from the standardization of prioritization criteria to ensuring the proper employment of referral protocols in diverse locations assisted by overloaded health workers with different backgrounds and perceptions. Efforts in decentralizing patient referral to primary care still face the growing dilemmas and challenges of expanding the coverage of health services while putting pressure on risk assessment, as well as sustaining the autonomy of physicians’ work while respecting the eligibility when ordering waiting lists.
CONCLUSION:
A major strength of this work is on the method to organize and aggregate qualitative data using visual representations. Limitations concerning the reach of fieldwork in vulnerable and hardly accessible areas were overcame using snowball sampling techniques, making more participants accessible.</description><subject>Accessibility</subject><subject>Case studies</subject><subject>Family physicians</subject><subject>Field study</subject><subject>Fieldwork</subject><subject>Grounded theory</subject><subject>Health care</subject><subject>Health services</subject><subject>Medical personnel</subject><subject>Medical referrals</subject><subject>Physicians</subject><subject>Primary care</subject><subject>Qualitative analysis</subject><subject>Resource availability</subject><subject>Risk assessment</subject><subject>Standardization</subject><issn>1051-9815</issn><issn>1875-9270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNptkdtqGzEQhkVpaY43eYAg6EVCYFsdvJaUu5BTCwZDScjlIksjZ8N6lUjagPMUfeSOWaeF0quZ0Xzza5ifkCPOvkoh5beH-c9KSCaE_kB2uVZ1ZYRiHzFnNa-M5vUO2cv5iTFkmPlMdqQymtWG75JfV-CgL8l27VvbL2mCAAkr-pzamNrSvtnSxp6WSJfQw9ixrrSbV0iZ2kLLI2zwlU1r6mwC2sErdOf0gr4MqFtQ4RWwk4HmMvg1XWDq6UYVJ29THHqP9d0jxLQ-IJ-C7TIcbuM-ub-5vrv8Xs3mtz8uL2aVk2xaKqVC0DjFDXfaKPDOeW-MDwutWOALKb3wDsCEUHutw9RbzcRkarjwKky03Ceno-5zii8D5NKs2uyg62wPcciN0EYwzg1TiH75B32KQ-pxu0ayujZKqYlE6mykXIo54x2b7U0azpqNTw361Iw-IXy8lRwWK_B_0HdjEDgZgWyX8Pe__0j9BqJDnSo</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Jatobá, Alessandro</creator><creator>Bellas, Hugo</creator><creator>Arcuri, Rodrigo</creator><creator>Sobral, André Luiz Avelino</creator><creator>Bulhões, Bárbara</creator><creator>Vianna, Jaqueline</creator><creator>de Castro Nunes, Paula</creator><creator>d’Avila, Adriana Lourenço</creator><creator>de Carvalho, Paulo Victor Rodrigues</creator><general>SAGE Publications</general><general>IOS Press BV</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240101</creationdate><title>Decentralizing referral prioritization to general practitioners at the primary care level: A qualitative case study based on the Grounded Theory</title><author>Jatobá, Alessandro ; Bellas, Hugo ; Arcuri, Rodrigo ; Sobral, André Luiz Avelino ; Bulhões, Bárbara ; Vianna, Jaqueline ; de Castro Nunes, Paula ; d’Avila, Adriana Lourenço ; de Carvalho, Paulo Victor Rodrigues</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c306t-77ff8ded191c897edccdd99dfb870f1b33d2dcee9ff5d88f6da80246912d7f483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Accessibility</topic><topic>Case studies</topic><topic>Family physicians</topic><topic>Field study</topic><topic>Fieldwork</topic><topic>Grounded theory</topic><topic>Health care</topic><topic>Health services</topic><topic>Medical personnel</topic><topic>Medical referrals</topic><topic>Physicians</topic><topic>Primary care</topic><topic>Qualitative analysis</topic><topic>Resource availability</topic><topic>Risk assessment</topic><topic>Standardization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jatobá, Alessandro</creatorcontrib><creatorcontrib>Bellas, Hugo</creatorcontrib><creatorcontrib>Arcuri, Rodrigo</creatorcontrib><creatorcontrib>Sobral, André Luiz Avelino</creatorcontrib><creatorcontrib>Bulhões, Bárbara</creatorcontrib><creatorcontrib>Vianna, Jaqueline</creatorcontrib><creatorcontrib>de Castro Nunes, Paula</creatorcontrib><creatorcontrib>d’Avila, Adriana Lourenço</creatorcontrib><creatorcontrib>de Carvalho, Paulo Victor Rodrigues</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Work (Reading, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jatobá, Alessandro</au><au>Bellas, Hugo</au><au>Arcuri, Rodrigo</au><au>Sobral, André Luiz Avelino</au><au>Bulhões, Bárbara</au><au>Vianna, Jaqueline</au><au>de Castro Nunes, Paula</au><au>d’Avila, Adriana Lourenço</au><au>de Carvalho, Paulo Victor Rodrigues</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decentralizing referral prioritization to general practitioners at the primary care level: A qualitative case study based on the Grounded Theory</atitle><jtitle>Work (Reading, Mass.)</jtitle><addtitle>Work</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>77</volume><issue>4</issue><spage>1189</spage><epage>1203</epage><pages>1189-1203</pages><issn>1051-9815</issn><eissn>1875-9270</eissn><abstract>BACKGROUND:
Patient referral prioritizations is an essential process in coordinating healthcare delivery, since it organizes the waiting lists according to priorities and availability of resources.
OBJECTIVE:
This study aims to highlight the consequences of decentralizing ambulatory patient referrals to general practitioners that work as family physicians in primary care clinics.
METHODS:
A qualitative case study was carried out in the municipality of Rio de Janeiro. The ten health regions of Rio de Janeiro were visited during fieldwork, totalizing 35 hours of semi-structured interviews and approximately 70 hours of analysis based on the Grounded Theory.
RESULTS:
The findings of this study show that the obstacles to adequate referrals are beyond the management of vacancies, ranging from the standardization of prioritization criteria to ensuring the proper employment of referral protocols in diverse locations assisted by overloaded health workers with different backgrounds and perceptions. Efforts in decentralizing patient referral to primary care still face the growing dilemmas and challenges of expanding the coverage of health services while putting pressure on risk assessment, as well as sustaining the autonomy of physicians’ work while respecting the eligibility when ordering waiting lists.
CONCLUSION:
A major strength of this work is on the method to organize and aggregate qualitative data using visual representations. Limitations concerning the reach of fieldwork in vulnerable and hardly accessible areas were overcame using snowball sampling techniques, making more participants accessible.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>37980591</pmid><doi>10.3233/WOR-230228</doi><tpages>15</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1051-9815 |
ispartof | Work (Reading, Mass.), 2024-01, Vol.77 (4), p.1189-1203 |
issn | 1051-9815 1875-9270 |
language | eng |
recordid | cdi_proquest_miscellaneous_2892011907 |
source | Business Source Complete |
subjects | Accessibility Case studies Family physicians Field study Fieldwork Grounded theory Health care Health services Medical personnel Medical referrals Physicians Primary care Qualitative analysis Resource availability Risk assessment Standardization |
title | Decentralizing referral prioritization to general practitioners at the primary care level: A qualitative case study based on the Grounded Theory |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T06%3A19%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Decentralizing%20referral%20prioritization%20to%20general%20practitioners%20at%20the%20primary%20care%20level:%20A%20qualitative%20case%20study%20based%20on%20the%20Grounded%20Theory&rft.jtitle=Work%20(Reading,%20Mass.)&rft.au=Jatob%C3%A1,%20Alessandro&rft.date=2024-01-01&rft.volume=77&rft.issue=4&rft.spage=1189&rft.epage=1203&rft.pages=1189-1203&rft.issn=1051-9815&rft.eissn=1875-9270&rft_id=info:doi/10.3233/WOR-230228&rft_dat=%3Cproquest_cross%3E2892011907%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3055977743&rft_id=info:pmid/37980591&rft_sage_id=10.3233_WOR-230228&rfr_iscdi=true |