Fernando Amaral et al. João A. Granzotti Bruno G. Dantas Diogo C. Balestra
OBJECTIVE: To verify the pediatric cardiology outpatient clinic characteristics in Ribeirão Preto (RP) city, emphasizing reasons for referral, definitive diagnosis and outcome through analysis of patients seen in 3 distinct settings. METHODS: In 1996, 1,365 consecutive patients, aged 1 month to 14 years were seen: G1 (n = 562), public pediatric cardiology outpatient clinic; G2 (n = 420), private practice; G3 (n = 383) pediatric cardiology outpatient clinic at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Origin of the patients: G1: RP (78%) and region (22%); G2: RP (67%), region (25%), and other regions/states (8%); G3: RP (26%), region (43.5%), and other regions/states (30.5%). RESULTS: Reasons for referral: G1: murmur (71%), arrhythmia (8%), chest pain (7%), breathlessness (6.5%), other reasons (7.5%). G2: murmur (70%), chest pain (7%), arrhythmia (7%), breathlessness (4%), postoperative follow-up (4%), other reasons (8%). G3: murmur (56%), postoperative follow-up (24%), arrhythmia (4%), other reasons (16%). Patients lost to follow-up: G1: 31%, G2: 17%, G3: 3%. Final diagnosis: G1: 346 (89%) normal and 43 (11%) abnormal patients; G2: 268 (76%) normal and 82 (24%) abnormal patients; G3: 22 (6%) normal and 351 (94%) abnormal patients. Outcome: G1: discharge (89%), follow-up (11%); G2: discharge (76%), follow-up (24%); G3: discharge (6%), follow-up (94%). CONCLUSION: Clinical profile is different among the 3 groups (G1 and G2 are similar). Intervention in the Basic Health Units seems to be necessary to verify structural facilities and to offer basic pediatric cardiology training to pediatricians. It is important to verify the high index of patients lost to follow-up, particularly in G1. Structural and human resources are needed if adequate assistance is to be expected for the highly complex cases seen in G3. The pediatric cardiology public outpatient clinic should be maintained until resolution of cases by the pediatricians in the Basic Health Units improves.