Challenges of Referral to the National Network of Continuous Integrated Care: The Experience in a Hospital

Abstract

Introduction: In 2006, the National Network for Continuing
Integrated Care was created in Portugal to respond to the
needs of a population with growing comorbidities. The aim of
this study is to assess the length of hospital stay and medical
complications of patients referred to the network in the same
period of four different years.
Material and Methods: Observational, retrospective study
of medical patients with medical conditions referred from the
hospital in the months of April to June 2010, 2012, 2016 and
2019. Demographic, clinical and referral data were obtained
from clinical processes. Statistical analysis was performed with
IBM SPSS Statistics®, p < 0.05 was considered statistically
significant.
Results: 205 patients were included. The main reasons
for admission were infection (37.1%) and acute cerebrovascular event (35.6%) and for referral was functional rehabilitation
(79.5%). There was an increase in length of stay over the years
(p < 0.001) and from referral to hospital discharge, p = 0.04.
After clinical discharge, 42.9% developed medical complications and after hospital discharge, at least 31.3% needed to
be readmitted within 3 months. The number of complications
did not rise.
Discussion: The increase in hospital stays over the years
since the creation of the network implies an overload in hospital
health care, even though there is no increase in clinical complications before and after discharge.
Conclusion: There is a clear need to strengthen the network
and social support to the chronically ill and to create studies to
assess the economic and health impact of hospital referrals.