Resumen de Análisis del proceso de derivación del paciente hipertenso en España: Estudio DERIVA

Nieves Martell Claros, María Abad Cardiel, Beatriz Álvarez Álvarez, J. A. García Donaire, A. Galgo Nafria

• Introduction An adequate communication between levels of medical attention is the key point for optimal treatment and outcomes of the hypertensive population.

  Aims The aim of this study was to evaluate the adequacy of the hypertensive patients' derivation from Primary Care to Specialized Care. As secondary objectives, the information registered on the derivation report was assessed and concordance between derivation reason and final diagnosis was analysed.

  Design This is an observational, descriptive, multicentre study.

  Site Study conducted at the national level.

  Participants Specialty Care Physicians receiving hypertensive patients referred from primary care.

  Principal measurements On the baseline visit, the specialist physicians assessed the quality of the derivation records and attended the patient. After the study, final diagnosis and treatment is suggested on the final visit.

  Results 1769 subjects were included, mean aged 62,4 (13,6) years, 45% female. Time of diagnosis of hypertension was 8,0 (7,7) years. More than the half of the derivation records contained very good information (5,4%; CI 4,3-6,5) or sufficient (50,7%; CI 48,4-53,0). In 7,1% (IC 5,9-8,3) derivation cause was not specified. 74,7% of the derivations were considered as appropriate, though 30% were late. Concordance between derivation reasons and final diagnosis was low (kappa index 0,208).

  Conclusions A quarter of the hypertensive population is unnecessary derived to Secondary Care and 30% of the appropriately derived was late. We should improve the interrelation of attention in the hypertension and cardiovascular area between the both attention levels.