Next Article in Journal
The Role of Lipid Biomarkers in Major Depression
Previous Article in Journal
Impact of Menthol Smoking on Nicotine Dependence for Diverse Racial/Ethnic Groups of Daily Smokers
Article Menu
Issue 1 (March) cover image

Export Article

Open AccessArticle
Healthcare 2017, 5(1), 4;

Brazilian Specialists’ Perspectives on the Patient Referral Process

Department of Nursing, São Paulo State University UNESP, Botucatu 18618-970, Brazil
School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada
Author to whom correspondence should be addressed.
Academic Editor: Sampath Parthasarathy
Received: 20 September 2016 / Revised: 19 January 2017 / Accepted: 21 January 2017 / Published: 29 January 2017
Full-Text   |   PDF [201 KB, uploaded 29 January 2017]


Since 1988, healthcare has been considered a citizen’s right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world’s fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo. This paper reports specialists’ perspectives of the referral process. This was a phenomenological study that employed a qualitative research method with three components (description, reduction and comprehension). We conducted focus groups with 54 hospital residents from different specialties (surgery, medicine, obstetrics/gynecology, pediatrics) from July to October 2014. The main results showed lack of an adequate referral-return referral process resulting in treatment delays and inappropriate use of emergency services. Communications were impeded by lack of integrated, computerized booking and standardized referral-return referral processes; underlying lack of trust in primary care physicians; and patients’ inappropriate use of healthcare services. Although computerized systems will facilitate communications between primary and specialty care, other strategies are needed to promote collaboration between services, and ensure appropriate utilization of them. View Full-Text
Keywords: referral; consultation; specialties; primary care; communication; phenomenology referral; consultation; specialties; primary care; communication; phenomenology
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Juliani, C.; MacPhee, M.; Spiri, W. Brazilian Specialists’ Perspectives on the Patient Referral Process. Healthcare 2017, 5, 4.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Healthcare EISSN 2227-9032 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top