El fundamento científico de la función de filtro del médico general
AUTOR(ES)
Gérvas, Juan, Pérez Fernández, Mercedes
FONTE
Revista Brasileira de Epidemiologia
DATA DE PUBLICAÇÃO
2005-06
RESUMO
Health services are organized by levels of care, which improves outcomes. These levels are "filters" that lead to a progressive increase in the prevalence of diseases in higher levels of care. We studied and justified the role of the general practitioner as filter, or gatekeeper, to specialists and hospitals. This role leads to greater prevalence of diseases in the referral population. We analyzed empirical data on abdominal pain, chest pain and rectal bleeding as examples. As to rectal bleeding, the prevalence of rectum and sigma carcinomas increases from 0.1% in the population, to 2% in general practitioners' waiting rooms (as a consequence of personal and family filters), and to 36% in specialists' waiting rooms (as a consequence of the gate-keeping role general practitioners play). This increase in prevalence improves the positive predictive value of the specialist's diagnostic testing, and patient selection avoids unnecessary contacts of specialists with patients having benign causes of rectal bleeding (who remain at their appropriate family or general practitioners' level).
Documentos Relacionados
- El fundamento científico de la función de filtro del médico general
- La función de filtro del médico general y el papel de los especialistas en los sistemas de salud
- El filo de la navaja de la función filtro: reflexiones sobre la función clínica en el Sistema Único de Salud en Brasil
- La función del principio de la compensación de los órganos en el transformismo de Etienne Geoffroy Saint-Hilaire
- La función del funcionalismo: una exploración conceptual