Evaluación del subsistema de referencia de un centro de salud tipo a de la provincia de Bolívar - 2024

Abstract

Abstract: In rural areas of Ecuador, the referral subsystem faces structural, geographical, and administrative challenges that limit the continuity of medical care. Therefore, it is necessary to understand the compliance, document quality, and performance of the referral subsystem in healthcare facilities, based on regulations from the Ministry of Public Health. Objective: To evaluate the referral subsystem of the San Simón Type A Health Center in the province of Bolívar in 2024. Methodology: A descriptive, cross-sectional, and documentary study was conducted. Three instruments were applied: an institutional evaluation form, a regulatory compliance form, and an observation form for Form 053, which were used on 161 medical records. Results: Weaknesses were identified in infrastructure, human resources, and the quality of Form 053 completion. A lack of technical criteria, frequent errors in record-keeping, and deficiencies in the referral process were also observed. Conclusions: The subsystem presents limitations that compromise the efficiency and security of the reference process, especially in rural contexts. It is recommended to implement a technical-operational improvement plan focused on staff training, strengthening documentation, and improving connectivity and traceability.