World Health Organization. Epub 2005 Jul 28. In the statistical analysis, the grouping of variables was performed, and these variables were described in tables, as well as measures of central tendency and dispersion. (1998) highlighted the importance to provide an empirical context for the ongoing investigation of equity in the distribution of health care [29]. It has agreements with INRIA, Observatoire des . This service receives female patients with unsatisfactory or unexpected clinical management from seven Basic Health Units at Unify Health System - So Paulo, Brazil. Patterns of ambulatory care use for gynecologic conditions: a national study. Health services were characterized by the type of provided care; this analysis focused on three different sectors: primary sector (basic health unit and school health center), secondary sector (university hospital, hospital of medium complexity, and specialty ambulatory clinics), and tertiary sector (hospital of high complexity and hospital with cancer support). For Example, "Ambulatory Referral to Minimally Invasive Gynecology Surgery" Open Order Ensure Performing Region is Set to: External Order as the order is leaving your facility Set Preforming Location to Washington University or "167" Am J Obstet Gynecol. There were a higher proportion of non-inflammatory disorders of the female genital tract (62.36%, n=111) and diseases of the urinary system (29.78%, n=53) in the non-reproductive period. Records will be sent via mail or fax for those providers who do not use the portal. The chances of having benign breast disease and non-inflammatory disorders of the female genital tract during the reproductive period corresponds to being 3.61 (CI 1.0016.29) and 2.56 times (CI 1.584.16) higher, respectively, than during the non-reproductive period. Health services were characterized by the type of provided care; this analysis focused on three different sectors: primary sector (basic health unit and school health center), secondary sector (university hospital, hospital of medium complexity, and specialty ambulatory clinics), and tertiary sector (hospital of high complexity and hospital with cancer support). In Brazil, the health system is organized at levels of attention according to the complexity of care services, seeking to provide universal access, equity and equality [1,2,3,4]. Work loss associated with increased menstrual loss in the United States. 2004. http://bvsms.saude.gov.br/bvs/publicacoes/politica_nac_atencao_mulher.pdf. Thus, the clinical control of these patients through the incorporation of drug therapy, which can be performed in the primary and tertiary sectors, is fundamental to avoid high costs and reduce morbidities. CID-10 Classificao Estatstica Internacional de Doenas e. Problemas Relacionados Sade. Accessed 16 Oct 2017. To reach a physician at BWH, or to receive additional information about the hospital's services, call the toll-free Physician Referral Service number: 1-800-MD to BWH (1-800-638-6294). Foreman H, Weber L, Thacker HL. 2013;4:121. Botucatu, 2014;18 (51): 647 660; https://doi.org/10.1590/1807-57622013.0597. 2 It may not be possible to make an appointment with a gastroenterologist without a referral. Referral gynecological ambulatory clinic: principal diagnosis and distribution in health services Adna Thaysa Marcial da Silva, Camila Lohmann Menezes, Edige Felipe de Sousa Santos, Paulo Francisco Ramos Margarido, Jos Maria Soares Jr, Edmund Chada Baracat, Luiz Carlos de Abreu & Isabel Cristina Esposito Sorpreso REF1076: AMB Referral to MMP PSC Infectious Disease: p: 207-662-5522 f: 207-662-5526. In our study, 66.5% of cases referred to medium complexity received clinical treatment, reinforcing the importance of training health professionals in the treatment and follow-up of the main diagnoses in womens health. 2011;96(1):E1148. Ministrio da Sade. The datasets generated during and/or analyzed during the current study can be obtained by request. ATMS, JMSJ, ECB, LCA and ICES were involved with editing the manuscript. This number is staffed 8:00 a.m. - 5:30 p.m., Monday through Friday. 2017;130(4):67783. We excluded ectopic pregnancy because a major proportion of these cases are managed in the hospital rather than in an ambulatory clinic. ISSNe. For Example "Ambulatory Referral to Urogynecology" Open Order Ensure Performing Region is Set to: External Order as the order is leaving your facility Women also need routine gynecologic evaluations, which may be provided by a gynecologist, an internist, or a family practitioner; evaluations are recommended every year for all women who are sexually active or > 18 years. Starfield B, Shi L, Macinko J. %PDF-1.6 % Nedel et al. Google Scholar. The distribution of health services was based on the sector of origin (referencing) and the sector of destination, where the patient received care or returned to the place of origin (counter-referencing). Bookshelf J Women's Health. Regarding clinical-gynecologic characteristics, they are in their late reproductive period, are sexually active, have formed offspring (multiparity), have at least one associated morbidity and are non-smokers. Use of outpatient health services by women: a population-based study in southern Brazil. Our study was conducted in a training program with an emphasis on womens health [18, 19], and the results therefore found in the main health diagnoses identified may be themes of continuing education. endstream endobj 60 0 obj <. Simon AE, Uddin SFG. 2008;42(6):104152. Abdo CH, Oliveira Jr. WM, MoreiraJr. Rev Saude Publica. The use of ambulatory and hospital care services has limited results in the capacity to describe the search behavior of women in relation to obtaining integral health care [16, 17]; the gynecological concerns most often cited are menstrual disorders, other forms of normal bleeding of the female genital tract, inflammatory processes, and urogenital dysfunctions [1316]. 2005. Part of Mustard et al. Appointments. 2012;55(3):63550. 8600 Rockville Pike Accessibility Jos Maria Soares, Jr, Email: moc.liamtoh@514seraosj. The return to low assistance complexity was present in most cases regarding the distribution of the utilization of services. (2000) in a Brazilian study regarding a medical audit on the prenatal care program in the south of the country noted that the use of the epidemiological methods to organize health services is important to the quality of care [37]. 2000;34(4):32936. Cookies policy. Data were checked regarding information consistency after data collection, and the medical records were re-read when discrepancies were present. Obstet Gynecol. World Health Organization, 2003. J Women's Health. Luiz Carlos de Abreu, Email: rb.psu@solracziul. Obstet Gynecol. Specific issues that need to be addressed include training, patient selection, consenting issues, decisions to cancel/transfer as inpatients, and the management of common gynaecological problems. Interface (Botucatu). Solomon CG, Hu FB, Dunaif A, et al. Int J Environ Res Public Health. Diseases of the urinary system, general physical examination, contraception and procreation are health diagnoses that remain in the primary and secondary sectors in the distribution of health services. Cheon C, Maher C. Economics of pelvic organ prolapse surgery. dos Santos Fernandes AM, Yamada EM, de Azevedo Sollero C, Lemes LCP. In relation to the presence of concomitant diseases, 17.78% (n=72) had two or more associated morbidities, and 79.48% (n=275) did not smoke. We have a secure online referral service to help you refer patients to Mayo Clinic and view their clinical results, including: Mayo Clinic has agreements with many insurance carriers, third-party administrators and employers. This site needs JavaScript to work properly. Fam Pract. A p value <0.05 was considered to be statistically significant. An obstetrician-gynecologist, or OB-GYN, has expertise in female reproductive health, pregnancy, and childbirth. The world health report 2003: shaping the future. With regard to the destination of the patients, following the distribution of health services utilization since the Womens Health Ambulatory Clinic of the University Hospital at So Paulo University (Fig. In addition, the chances of having disorders of the breast and non-inflammatory disorders of the female genital tract during the reproductive period corresponds to being 3.61 (CI 1.0016.29) and 2.56 times (CI 1.004.16) higher, respectively, than the chance of having the disease in the non-reproductive period (p<0.001). Experienced nursing staff is available 24/7 to coordinate direct admission, emergency department evaluation or inpatient consultation for your patients at any Mayo Clinic Hospital location. Distrito de sade de origem e caractersticas sociodemogrficas das mulheres atendidas em unidade secundria de referncia do Sistema nico de Sade em Campinas. Mustard CA, Kaufert P, Kozyrskyj A, Mayer T. Sex differences in the use of health care services. Ambulation. Abnormal uterine bleeding is also a risk factor for acute hemorrhage and cardiovascular disease, which implies morbidity and mortality [43]. The ethics committee waived the need for informed consent by participants in the current study. Technical efficiency of womens health prevention programs in Bucaramanga, Colombia: a four-stage analysis. Article In Table2, the main health diagnoses for non-oncological gynecology, considering both reproductive and non-reproductive periods, were the non-inflammatory disorders of the female genital tract (81.07%, n=347) and diseases of the urinary system (22.66%, n=97). PubMed Nicholson et al. Lynn AM, Lai LJ, Lin MH, Chen TJ, Hwang SJ, Wang PH. Auditoria mdica: programa de pr-natal em posto de sade na regio Sul do Brasil. Poltica Nacional de Ateno integral Sade da Mulher: princpios e diretrizes. Mayo encourages referring physicians to register for a portal account. Perinatology is a specialty of medicine focused on the care of women and their unborn babies during pregnancy. 2007;24(6):5327. Think before you speak. Ministrio da Sade. Epub 2008 Jan 28. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Stormo AR, Saraiya M, Hing E, Henderson JT, Sawaya GF. 10a rev. The traditional health system information and care provided are limited due to lack of knowledge of the characteristics of those who do not seek health services. Google Scholar. Rodrigues et al. Koo M, Chen CH, Tsai KW, MC L, Lin SC. The average age of menarche was 13.0years old (sd2.20), onset of sexual activity was 18.3years old (sd8.70), and menopause was 49.0years old (sd6.0). This means the patient is able to walk around. The gynecological and obstetric histories found that the patients resemble those described by other authors in the national territory, such as menarche and menopausal ages [22,23,24] and the presence of sexual dysfunctions [25], with no variation among other studies performed in developed countries [26]. Mayo Clinic obstetric and gynecology physicians are committed to collaborating with referring physicians. This may corroborate with the specificity of this entity and the importance of the medical specialist in the care assistance of this entity [49]. The studied women presented non-inflammatory disorders of the female genital tract and diseases of the urinary system as determined by gynecological diagnoses. Tsai MC, Goldstein SR. Office diagnosis and Management of Abnormal Uterine Bleeding. The female patients present non-inflammatory disorders of the female genital tract (81.07%, n=347) and diseases of the urinary system (22.66%, n=97) among the gynecological diagnoses. 1994;116:1110. ATMS, JMSJ, ECB, LCA and ICES, were involved with data management. The ethics committee waived the need for informed consent by participants in the current study. 2007;13(2):11521. Please enable it to take advantage of the complete set of features! Ct I, Jacobs P, Cumming DC. da Silva, A.T.M., Menezes, C.L., de Sousa Santos, E.F. et al. The ethics committee waived the need for informed consent by participants in the current study. The Chi-square test for qualitative variables, Crude Odds Ratio, and 95% confidence interval were performed to verify the difference between the frequency of the categories and the reproductive periods. We excluded patients diagnosed with pregnancy, childbirth, puerperium, and cancer, as well as those whose information was incomplete. The gynecological and obstetric histories found that the patients resemble those described by other authors in the national territory, such as menarche and menopausal ages [2224] and the presence of sexual dysfunctions [25], with no variation among other studies performed in developed countries [26]. The female patients present non-inflammatory disorders of the female genital tract (81.07%, n=347) and diseases of the urinary system (22.66%, n=97) among the gynecological diagnoses. Some OB-GYNs offer a wide range of general health services similar to your primary care doctor. Eur J Obstet Gynecol Reprod Biol. Van Wijk CMG, Kolk AM, Van Den Bosch WJ, Van Den Hoogen HJ. The https:// ensures that you are connecting to the Ambulatory medical services utilization for menstrual disorders among female personnel of different medical professions in Taiwan: a nationwide retrospective cohort study. The data were feasible, acceptable and reliable (consistent). The chances of diagnosis of non-inflammatory disorders of the female genital tract and general physical examination, contraception and procreation are significantly different (p<0.05) during the non- reproductive period. 2015;15:66. Rev Saude Publica. Amb. What does AMB stand for in Neurosurgery? RR=5.97 (1.45: 24.70) [Non-inflammatory disorders of female genital tract (N80-N99)]; RR=1.97 (0.52: 7.50) p=0.33 [Disorders of breast (N60-N64)], Proportion of gynecology diagnoses in relation to the distribution of health sectors at Womens Health Ambulatory Clinic of the University Hospital at So Paulo University, So Paulo -Brazil (20122014). HHS Vulnerability Disclosure, Help All the information regarding clinical-demographic and gynecological profiles, type of treatment, and medical referrals were extracted from standardized gynecologic medical records, and a database in Excel format was created. Trends in seeing an obstetriciangynecologist compared with a general physician among US women, 20002015. J Clin Nurs. ATMS, JMSJ, ECB, LCA and ICES, were involved with data management. Data were selected from a convenience sample of 428 charts from the first medical visit. Data were collected from medical records of the patients. Manage cookies/Do not sell my data we use in the preference centre. Jha S, Moran P, Blackwell A, Greenham H. Integrated care pathways: the way forward for continence services? Would you like email updates of new search results? Proportion of the number of patients in relation to the distribution of health services to the sector of destination. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. PubMed Central Obstet Gynecol. In our study, 66.5% of cases referred to medium complexity received clinical treatment, reinforcing the importance of training health professionals in the treatment and follow-up of the main diagnoses in womens health. Forman MR, Mangini LD, Thelus-Jean R, Hayward MD. 2001;184(4):52330. In Table2, the main health diagnoses for non-oncological gynecology, considering both reproductive and non-reproductive periods, were the non-inflammatory disorders of the female genital tract (81.07%, n=347) and diseases of the urinary system (22.66%, n=97). Suggest. The research project was analyzed and approved by the Ethics Committee of the Medical School of the University of So Paulo, according to the protocol no. PubMedGoogle Scholar. We grouped the principal diagnoses in five disease categories [14]: 1) Diseases of the urinary system (N30 - N39) urinary incontinence, cystitis, neuromuscular disorders of the bladder, other disorders of the urinary system, urethritis and urethral syndrome, urethral stricture, other urethral disorders, bladder disorders; 2) Disorders of the breast (N60 - N64) - benign mammary dysplasias, inflammatory disorders of breast, hypertrophy of breast, unspecified lump in breast, fistula and fissure of the nipple, fatty necrosis of the breast, atrophy of breast, non-associated to birth galactorrhoea, mastodynia, solitary cyst of the breast; 3) Inflammatory diseases of female pelvic organs (N70 - N77) - lower genital tract infections (herpes, gonorrhea, chlamydia, Trichomonas, Candida, vulvovaginitis, syphilis), infectious vulvar lesions, inflammatory disease of the upper genital tract, such as disease of the uterus, ovaries, fallopian tubes including cervicitis, salpingitis, endometritis, and tube-ovarian abscess, diseases of Bartholin gland, vulvovaginal ulceration and inflammation; 4) Non-inflammatory disorders of the female genital tract (N80 - N99) genital dysplasia (precancerous lesions of the vulva, vagina, and cervix), menopausal disorders, menstrual disorders and hormonal dysfunction (dysfunctional uterine bleeding, ovarian hyperestrogenism, ovarian dysfunction, or irregular menstrual Cycles), endometriosis, malignancy of the reproductive tract (carcinoma in situ and invasive disease of the genital tract) benign disorders of the uterus and ovaries (benign ovarian cysts or tumors, leiomyomas, endometrialpolyps, orhyperplasia), infertility; 5) General physical examination, contraception and procreation (Z00 - Z31) general examination and investigation of people without complaints about contraception, general advice about contraception, insertion of contraceptive devices (intrauterine), sterilization and measures of procreation [10, 11]. The levels of secondary and tertiary care are responsible for performing diagnoses and specific treatments, as well as providing the primary level of continuing education in service [57]. Jha S, Gopinath D. Prolapse or incontinence: what affects sexual function the most? The final destination of patients mostly to the primary sector is considered satisfactory. With regard to the destination of the patients, following the distribution of health services utilization since the Womens Health Ambulatory Clinic of the University Hospital at So Paulo University (Fig. Instead, descriptive studies of the use of health care services typically document higher per capita use by women during the adult reproductive period [14, 3032]. Clinical-demographic characteristics, gynecological and obstetric history of patients seen at the Womens Health Ambulatory Clinic of the University Hospital at So Paulo University, So Paulo, Brazil (20122014). Revista de Cincias Mdicas. 2008:284351. Moreover, the non-inflammatory disorders of the female genital tract were the non-oncological gynecological health diagnosis most referred to in the tertiary sector, demonstrating [46, 47] the financial impact on the health system. The non-inflammatory disorders of the female genital tract were 71.52% (n=236); diseases of the urinary system were 13.33% (n=44); inflammatory diseases of female pelvic organs were 6.67% (n=22); general physical examination, contraception and procreation were 4.85% (n=16) and diseases of the breast were 3.64% (n=12); these are the most frequent non-oncological gynecological diagnoses during the reproductive period in the visits of these women. Rawaf S, De Maeseneer J, Starfield B. 2014;30(10):71720. Data were collected from medical records of the patients. From sneezes to adieux: stages of health for American men and women. Thus, the clinical control of these patients through the incorporation of drug therapy, which can be performed in the primary and tertiary sectors, is fundamental to avoid high costs and reduce morbidities. O difcil acesso a servios de mdia complexidade do SUS: o caso da cidade de So Paulo, Brasil. Brazil's family health strategydelivering community-based primary care in a universal health system. What does OB / GYN stand for in medical category? The aim of ambulatory gynaecology is to admit, treat and discharge the patient on the same day in an outpatient setting. Disclaimer. We use cookies to ensure that we give you the best experience on our website. CAS Perinatologists are highly specialized doctors who provide comprehensive care throughout the entire prenatal period. Utilization of ambulatory medical care by women: United States, 1997-98. Amb Referral To Perinatology. Low-assistance complexity followed in most cases. This may corroborate with the specificity of this entity and the importance of the medical specialist in the care assistance of this entity [49].
amb referral to gynecology