Coordination between family doctors and home hospitalization facilitates emergencies in Leiria

A project developed by the Leiria Local Health Department that allows family doctors to refer patients directly to a home hospitalisation unit will help reduce the number of emergencies.

“This helps to ease the burden of emergency services, hospitalizations and to provide greater humanization of the care provided at home, even in the hospital itself,” André Rainho Dias, a general and family medicine doctor at the Vitrius Family Health Unit (USF) in Marinha Grande, explained to Lusa.

Until now, family doctors had to refer patients to the emergency department to be admitted to the UHD: “Imagine what it means to have a patient who is already weak and have to explain to him that he is going to an emergency where maybe 100 people will be seen and where they will wait 24 hours until they are called,” said André Rainho Dias.

These are not emergencies, but situations like urinary tract infections that only respond to a hospital antibiotic, “and that obviously means getting a green bracelet.”

Thanks to this project, doctors can make a referral just as if they were consulting a specialist: “The ability to refer directly to UHD is undoubtedly a big advantage. If not on the same day, then the next day.” the user will receive an assessment.”

These referrals may also be directed towards palliative care or monitoring of cancer patients.

“It matters whether a person dies at home with his family or dies in a hospital. This very direct contact allows us to avoid an emergency. This is humanizing medicine.”

André Rainho Dias also stressed the importance of “prompt collaboration with a fellow physician, who often has additional diagnostic tools” that are not available in medical centers.

“They can quickly get to the user’s home and they may even understand that he needs treatment or even go to the hospital.”

UHD Director Amalia Pereira reported that in 2023, 23% of patients admitted to the hospital were urgent: “Because we are a ULS, it did not make sense for us to be tied exclusively to hospital referrals. In 2023, we started with a pilot project at USF Vitrius and Nobox helped us modify the system to make referrals more flexible.”

Family physicians refer to the UHD unit, where the patient is assessed within a maximum of 24 hours to determine whether he or she meets the unit’s criteria or requires traditional hospitalization.

“We still need to allow nurse referrals when users don’t have a family doctor,” the doctor said.

Amália Pereira stressed that “these are small measures that will improve the work of family doctors, the quality of care provided to patients, free up beds and reduce the number of people in emergency departments. This is an improvement in health.”

UHD operates at a distance of up to 30 kilometers and 30 minutes, with only 12 beds, which is not enough for the number of requests. They cannot cover the entire area of ​​influence of ULS while they only have one team. “The ideal would be to have two units: one in Leiria and one in Alcobaça,” said Amália Pereira.

Diogo Fernandes Silva, co-founder of Nobox and a doctor specialising in public health, explained to Luce that this is a project that arose from a grant for the development of human capital in health, created by the Portuguese Association of Hospital Administrators, and that the Leiria Team won. “The main objective is to help ULS and health organisations rethink the way they deliver care and manage teams. Nobox provides all the consultancy for these projects,” he explained, adding that this has helped to overcome barriers and inform doctors.

EMC // SSS

Lusa/The End