Family Practice, Vol 15, 158-164, Copyright © 1998 by World Organization of Family Doctors
H Tabenkin, B Oren, D Steinmetz, A Tamir and E Kitai
OBJECTIVE: We aimed to analyse factors influencing referral of patients by
primary care physicians to specialist consultants at the beginning of the
era of direct access to specialists in Israel. METHODS: We carried out a
study of referrals by family physicians to specialists over a continuous
period of 3 months. Twenty-four certified family physicians filled in a
questionnaire detailing referrals during the study period. All patients
were referred for consultation to a specialist at regional speciality
clinics or hospital out-patient departments. RESULTS: Ten physicians met
the study conditions. In 1140 of 10896 (10.5%) visits, patients were
referred to specialist consultants. The percentage of referral ranged from
7.4 to 15.9%. The difference between the physicians with the lowest and
highest rates of referral was statistically significant (P < 0.0001).
The variance in referral rates was not explained by significant differences
in physician or practice variables. The types of specialists to whom the
most referrals were made were orthopaedic surgeons, ophthalmologists,
dermatologists, ear, nose and throat, general surgeons and plastic
surgeons. There was a significant correlation between the type of
specialist and the age of the patient. Older patients were referred more
frequently to urologists, cardiologists and ophthalmologists, while younger
patients were referred more frequently to ear, nose and throat specialists
and gynaecologists (P < 0.01). CONCLUSIONS: The results of this study
can be used as an aid for decision makers in the health services for
determining policy. Direct access to some specialties might be appropriate,
but not to all. Adoption of a policy based on these findings could lead to
reduced health care costs by reducing the burden on hospital emergency
rooms. It might also increase patient satisfaction in that the patients
will have greater freedom of choice. On the other hand, more appropriate
training of family physicians and more extensive self- and peer-quality
assurance will increase the primary physician's knowledge and ability to
diagnose and treat a broad range of problems and improve the level of care.
ORIGINAL CLINICAL RESEARCH
Referrals of patients by family physicians to consultants: a survey of the Israeli Family Practice Research Network
Department of Family Medicine, Northern Region and H'emek Medical Center, Afula, Israel.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D E. Feldman, O Schieir, A J Montcalm, S Bernatsky, M Baron, and The McGill Early Inflammatory Arthritis Research G Rapidity of rheumatology consultation for people in an early inflammatory arthritis cohort Ann Rheum Dis, November 1, 2009; 68(11): 1790 - 1791. [Full Text] [PDF]
|
|
|
|
 |
|
 C. B. Forrest A Typology of Specialists' Clinical Roles Arch Intern Med, June 8, 2009; 169(11): 1062 - 1068. [Abstract] [Full Text] [PDF]
|
|