Barriers and Benefits of the Scheduled Telephone Referral Model (DETELPROG): A Qualitative Approach

Luis Miguel Azogil-López, Valle Coronado-Vázquez, Juan José Pérez-Lázaro, Juan Gómez-Salgado and Esther María Medrano-Sánchez
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Luis Miguel Azogil-López: Health Service of Andalusia, Primary Health Center Bollullos de la Mitación, 41110 Seville, Spain
Valle Coronado-Vázquez: Health Service of Castilla La Mancha, Primary Health Center Illescas, 45200 Toledo, Spain
Juan José Pérez-Lázaro: Andalusian School of Public Health, 18080 Granada, Spain
Juan Gómez-Salgado: Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
Esther María Medrano-Sánchez: Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41013 Sevilla, Spain

IJERPH, 2021, vol. 18, issue 10, 1-16

Abstract: The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried out through six semi-structured interviews and two focus groups in a sample of eleven PCPs and five HAPs. Interviews were carried out from September 2019 to February 2020. Data were analysed by creating the initial categories, recording the sessions, transcribing the information, by doing a comprehensive reading of the texts obtained, and analysing the contents. The results show that DETELPROG gives the PCP greater prominence as a patient’s health coordinator by improving their relationship and patient safety; it also improves the relationship between PCP and HAP, avoiding unnecessary face-to-face referrals and providing safety to the PCP when making decisions. The barriers for DETELPROG to be used by PCP were defensive medicine, patients’ skepticism in DETELPROG, healthcare burden, and inability to focus on the patient or interpret a sign, symptom, or diagnostic test. For HAP, the barriers were lack of confidence in the PCP and complexity of the patient. As a conclusion, DETELPROG referral model provides a lot of advantages and does not pose any new barrier to face-to-face referral or other non-face-to-face referral models, so it should be implemented in primary care.

Keywords: qualitative research; referral; electronic consultation; telemedicine; primary care; waiting lists; patient safety; quality of healthcare; primary care physicians; hospital attending physicians (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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