RETROSPECTIVE ANALYSIS OF THE REFERRAL PROFILE OF A PRIMARY HEALTH CARE TEAM IN THE CENTRAL REGION OF THE CITY OF RIO DE JANEIRO

Abstract

Introduction: Understanding the profile of the population served by Family Health Strategy (FHS) teams is essential to guide practices that promote equitable and comprehensive access to care. In large urban centers such as Rio de Janeiro, Primary Health Care (PHC) serves as the coordinator of care, yet faces structural and organizational limitations that compromise its resolutive capacity. The Regulatory System (SISREG) plays a central role in organizing access to specialized consultations and diagnostic procedures. Complexo do Turano, a territory marked by high social vulnerability and urban precariousness, offers an emblematic setting for analyzing how regulated demands reflect concrete health needs and systemic limitations. Objective: To retrospectively analyze referrals made via SISREG by a family health team working in Complexo do Turano between October 2023 and October 2024, identifying the frequency, request profiles, and average waiting times. Methods: This was a descriptive, retrospective study based on secondary data extracted from SISREG. Variables included the requested specialty or exam, request status, assigned risk level, and waiting time. Data were manually collected, reviewed by two researchers, and analyzed using descriptive statistics with Excel and Python (Pandas and Matplotlib). The project was approved by the Research Ethics Committee under approval number 7.633.047. Results: Among the 4,195 registered users, 1,018 (24%) used SISREG, resulting in 1,935 requests. Of these, 56% were scheduled, 26% remained pending, 8% resulted in no-shows, and 4% were canceled. The average waiting time was 95 days (range: 1–390). The most frequently requested specialties were ophthalmology (534), physical therapy (83), and gynecology (80). Among gynecological referrals, 43% were for tubal ligation. Regarding diagnostic procedures, non-obstetric transvaginal ultrasound accounted for 25% of the 327 ultrasound requests. Conclusions: The findings revealed prolonged waiting times and concentrated demands in ophthalmology, physical therapy, and reproductive planning, reflecting both the population’s health needs and weaknesses in the care network. The study highlights the importance of expanding access to long-acting reversible contraceptives (LARCs), strengthening collective actions in sexual and reproductive health, and qualifying regulatory processes within PHC, contributing to more effective and equitable practices.