Author/Editor		Živčec-Kalan, Gordana; Šuta, Franc
Title		Navodila za prvo nenujno napotitev na sekundarni nivo zdravstvene obravnave
Translated title		Instrumentations for first non-urgent referral to the secondary health care level
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 44, št. Suppl 1
Publication year		2005
Volume		str. 171-80
Language		slo
Abstract		The health care system has become increasingly complex, expensive and less transparent. Because of the rapid development of medicine and changes in society, doctors are facing a restructuring of the health care system (transfer of secondary level cases), with new requirements imposed by the legislation and insurance companies, and new expectations of increasingly well informed and insured patients. Sadly, Slovenia ranks last among European Union members in terms of the number of doctors per 100,000 inhabitants. The recommendations of individual professions concerning referrals (gastroenterology, neurology) have not fulfilled expectations. It is probably not possible to ensure a higher or lower number of referrals via clinical guidelines. Major activities should ideally be focused on appropriate referrals, irrespective of their number. The number of hospital referrals varies markedly among general practitioners, which can largely be explained by differences between patients in the general population. When used properly, electronic communication can improve the doctor-patient relationship and the accessibility of medical care, reduce waiting times and perhaps even the costs of medical care. New diagnostic possibilities, such as e.g. genetic counseling, are creating completely new relationships both between patients and their personal doctors as well as between doctors of all levels. In order to improve communication between the primary and secondary level, we have compiled recommendations for preparing patients for their first non-urgent referral to a specialist, which are based on positive experiences that have resulted from recommendations for patients for procedures under anesthesia.
Summary		Sistem zdravstvenega varstva je postal vse bolj zapleten, drag in nepregleden. Zaradi hitrega razvoja medicine in družbenih sprememb se zdravniki soočajo s spremembo v organiziranosti zdravstvene službe (prenos obravnav s sekundarnega nivoja), z novimi zahtevami zakonodajalca in zavarovalnice ter z novimi pričakovanji vse bolj poučenih zavarovancev. Slovenija zavzema neslavno zadnje mesto med državami Evropske unije po številu zdravnikov na 100.000 prebivalcev. Priporočila posameznih strok o napotitvah (npr. gastroenterologija, nevrologija) niso izpolnila pričakovanja. Zagotoviti večje ali manjše število napotitev skozi klinične smernice verjetno ni mogoče. Večje aktivnosti je boljše usmeriti v večje število ustreznih napotitev, ne glede na njihovo število. Število napotitev v bolnišnico je izrazito različno med zdravniki splošne medicine, kar je v največji meri razloženo z razlikami med bolniki v populaciji. Če se pravilno uporablja, lahko elektronsko sporazumevanje izboljša sporazumevanje bolnik - zdravnik, izboljša dostopnost do oskrbe, skrajšuje čakalne dobe in morda zmanjšuje stroške same oskrbe. Nove diagnostične možnosti, kot npr. genetsko svetovanje, odpirajo povsem nove odnose tako med bolniki in osebnimi zdravniki, kot tudi med zdravniki vseh nivojev. Z namenom izboljšanja sporazumevanja med primarnim in sekundarnim nivojem smo pripravili priporočila za pripravo bolnika na prvo nenujno napotitev k napotnemu specialistu. Izhajali smo iz pozitivnih izkušenj, ki smo si jih pridobili pri pripravi priporočil za pripravo bolnika za poseg v anesteziji.
Descriptors		PRIMARY HEALTH CARE REFERRAL AND CONSULTATION