The proposal for the Pediatric Hospital Referencing Network, open for public consultation until November 10, was developed by the National Commission on Women’s, Children’s and Adolescents’ Health (CNSMCA), led by Alberto Caldas Afonso. Its primary aim is to promote quality, accessible, and integrated pediatric healthcare, ensuring an adequate national response.
In a conversation with Lusa, Ricardo Jorge da Costa, President of the College of Pediatrics, indicated that the new network mainly updates the 2022 reorganization, considering changes in hospitals since then.
“Some hospitals have significantly altered their structures due to considerable mobility of pediatricians and pediatric specialties,” he stated, noting some services have weakened while others have strengthened.
The network reorganizes each service based on current capacity, guaranteeing appropriate patient responses, he explained.
“It has established a quicker method for contact and connection between hospitals,” allowing complex cases to be directed to multidisciplinary reference teams without time loss or resource dispersion.
Ricardo Jorge da Costa emphasized that the network is dynamic. A hospital might lack the capacity for a specific case and thus refer patients to facilities with the requisite resources. However, if it develops capabilities, it can take on new roles, altering the referral network.
“Instead of overburdening a specialized hospital with patients from various services in the same region, the network enables some cases to be redirected to units that previously did not have this capacity but now, following updates and service revamps, can assume new responsibilities,” he explained.
Addressing regional disparities, the specialist remarked, “The country is very heterogeneous regarding pediatric resources.”
“In coastal areas, the population is large, with many highly specialized hospitals. In the interior, populations are sparse and aged, with fewer pediatricians and subspecialties,” he noted.
It isn’t feasible to maintain all specialties for such a small population without risking lack of experience and expertise, especially in complex or emerging conditions, such as neurodevelopmental disorders.
“In these cases, patients rely on reference centers, which already have teams, laboratories, and research and care protocols,” he said.
He highlighted the long distances families in the interior must travel to access specialized care, a problem the new network aims to mitigate.
In isolated areas like the Serra da Estrela, families may need to travel around 200 kilometers for specialized pediatric care in Coimbra, with no direct highway access.
Through direct contact channels between hospitals and specific training for peripheral units, patients can be evaluated locally and referred only as needed, allowing peripheral hospitals to gradually build capacity and expertise via coordination with reference centers.
The network is currently under public consultation and open to discussion. Ricardo Jorge da Costa mentioned that some pediatricians have raised questions that will be addressed with the CNSMCA.
“Our goal is for the document to be effective and improve care, whether in the timing for organizing patient transfers or studies or in the proper use of finite resources,” he stated.
