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Research

Explaining variation in referral from primary to secondary care: cohort study

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c6267 (Published 01 December 2010) Cite this as: BMJ 2010;341:c6267

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Re: Explaining variation in referral from primary to secondary care: cohort study

Three color codes can be given by peripheral health worker on the health card of a pregnant woman: One code for immediate emergency care and the other for level of care required (primary, secondary or tertiary care) by the subject and third code would signify the severity of disease.

Severity of disease e.g. severe anaemia (< 7 gm% of hemoglobin ) will be coded red, mild to moderate (7-11 gm%) as orange and normal (>11 gm%) as green in the column provided in the card.

For immediate emergency care e.g. in severe anaemia close to term should be immediately referred to higher center where blood transfusion can take place and should be marked as red in the boxes provided for time of care and type of skilled care (third code). Whereas, the mild to moderate can be managed at the place close to the subject e.g. subcentre (green).

Similarly the color code can be developed for all the obstetric complications. Not only it will be alerting the patient as well as health worker to the gravity of the situation (at a glance), but it will also increase the health care utilization by giving a visual coding and mobilizing the patient and their families.

Competing interests: No competing interests

06 June 2012
Anuradha Jaswal
Gynaecologist
Neeru Gupta
Obgyn Clinic
G-70, Preet Vihar, New Delhi-110092