Improving referral activity on primary–secondary care interface using an electronic decision support system

Mariotti, Giuliano; Gentilini, Maria; Dapor, Valter

doi:10.1016/j.ijmedinf.2013.08.003

Cited by 8 publications

(10 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…57 Communication between general physicians in CHSs and specialists in hospitals is also helpful for patient-care feedback and has a positive effect on referral and cooperation between primary-care physicians and specialists. 58 China's medical reform in 2009 emphasized the training and education of medical staff working in CHSs to achieve, as soon as possible, the goal of having staff in CHSs to include qualified GPs and to facilitate the communication between CHSs and hospitals. CHSs should be provided with more funding, better technology, and more staff, and be equipped with unused hospital resources under governmental guidance.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing two-way referral between hospitals and the community in China: A system dynamics simulation model

Zhang

et al. 2017

SIMULATION

View full text Add to dashboard Cite

Background: Two-way referrals between hospitals and community healthcare systems (CHSs) are important for optimizing the distribution of medical resources and enabling resource sharing, but referrals are always from CHSs to hospitals. A referral from the hospital to the community is rare in China; this has a highly negative impact on the long-term development of the Chinese health services. The aim of this study was to address influence factors in hospitalcommunity referrals. Methods: We constructed a system dynamics model to address the problem of the two-way referral between hospitals and CHSs and identified potential countermeasures and possible solutions. The Vensim DSS program was used to construct a system dynamics model to represent the problem through model description, causal loop diagrams, and stock and flow diagrams. Results: The model was used to perform intervention experiments, in which the influence on all the sectors of referrals could be observed by changing the system parameters. The experimental results showed a greater difference in medical costs between hospitals and CHSs, more investments to CHSs, higher levels of medical insurance of CHSs, and more referrals from hospitals to CHSs. Conclusions: The system can widen the price gap between hospitals and CHSs, increase information flow, improve medical insurance level of CHSs, and elevate the current level of CHSs through enabling two-way referral between hospitals and CHSs.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors influencing two-way referral between hospitals and the community in China: A system dynamics simulation model

Zhang

et al. 2017

SIMULATION

View full text Add to dashboard Cite

show abstract

“…The development of mechanisms for the gatekeeping by PHC is associated with improved outcomes in the transition from care to specialized care 20 . We can expand clinical care and increase PHC resoluteness through the coordination and regulation of the network, thus reducing the risk of excessive investigations and treatments 21 .…”

Section: Introductionmentioning

confidence: 99%

Acesso e regulação ao cuidado especializado no Rio Grande do Sul: a estratégia RegulaSUS do TelessaúdeRS-UFRGS

Katz

Roman

Rados

et al. 2020

Ciênc. saúde coletiva

View full text Add to dashboard Cite

Resumo Na Atenção Primária à Saúde (APS) acesso e integralidade são fortemente influenciados pela coordenação do cuidado, que por sua vez recebe impacto positivo da articulação de ações de telessaúde para a telerregulação da assistência. Criamos uma metodologia de telerregulação (Projeto RegulaSUS) baseada em protocolos específicos firmemente alicerçados em evidências. A partir de dados do sistema de regulação e do TelessaúdeRS exploramos os efeitos do RegulaSUS na APS e no acesso ao cuidado especializado. A metodologia foi capaz de criar protocolos abrangentes, com expressiva redução média da fila de consultas especializadas de 30% em 360 dias. Reduziu o tempo de espera na marcação de consultas em especialidades clínicas (mediana de 66 dias), mas não em cirúrgicas. Tempos de espera nos casos mantidos em fila variaram de forma inversa, aumentado em especialidades clínicas e diminuindo em cirúrgicas. O uso de teleconsultorias espontâneas aumentou com a exposição dos profissionais ao RegulaSUS. A intervenção tem potencial na integração de sistemas de saúde, principalmente em países de baixa e média renda, e faz com que a telessaúde atue como metasserviço, construindo redes eficientes, qualificadas e equânimes.

show abstract

“…The last years’ development of better e-communication and more advanced electronic referral decision support systems have facilitated an easier referral process [ 18 , 19 ], making it more convenient to complete the referrals during the consultation, which may be timesaving and associated with less work-load.…”

Section: Discussionmentioning

confidence: 99%

“…Improving the quality of the referral process is important to facilitate timely access to specialty care [ 15 – 17 ]. Studies have shown that better e-communication between GPs and hospital consultants and more advanced electronic referral decision may facilitate this process [ 18 , 19 ]. Continuous professional development (CPD) groups with certified supervisors, where the participants discuss clinical problems and difficulties in the consultation room can help young GPs to become more confident and safe in their role as a GP and specialist in family practice [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Typologies in GPs’ referral practice

et al. 2016

View full text Add to dashboard Cite

BackgroundGPs’ individual decisions to refer and the various ways of working when they refer are important determinants of secondary care use. The objective of this study was to explore and describe potential characteristics of GPs’ referral practice by investigating their opinions about referring and their self-reported experiences of what they do when they refer.MethodsObservational cross-sectional study using data from 128 Norwegian GPs who filled in a questionnaire with statements on how they regarded the referral process, and who were invited to collect data when they actually referred to hospital during one month. Only elective referrals were recorded. The 57 participants (44,5 %) recorded data from 691 referrals. The variables were included in a principal component analysis. A multiple linear regression analysis was conducted to identify typologies with GP’s age, gender, specialty in family medicine and location as independent variables.ResultsEight principal components describe the different ways GPs think and work when they refer. Two typologies summarize these components: confidence characterizing specialists in family medicine, mainly female, who reported a more patient-centred practice making priority decisions when they refer, who confer easily with hospital consultants and who complete the referrals during the consultation; uncertainty characterizing young, mainly male non-specialists in family medicine, experiencing patients’ pressure to be referred, heavy workload, having reluctance to cooperate with the patient and reporting sparse contact with hospital colleagues.ConclusionsTraining specialists in family medicine in patient-centred method, easy conference with hospital consultant and cooperation with patients while making the referral may foster both self-reflections on own competences and increased levels of confidence.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0495-y) contains supplementary material, which is available to authorized users.

show abstract

Improving referral activity on primary–secondary care interface using an electronic decision support system

Cited by 8 publications

References 12 publications

Factors influencing two-way referral between hospitals and the community in China: A system dynamics simulation model

Factors influencing two-way referral between hospitals and the community in China: A system dynamics simulation model

Acesso e regulação ao cuidado especializado no Rio Grande do Sul: a estratégia RegulaSUS do TelessaúdeRS-UFRGS

Typologies in GPs’ referral practice

Contact Info

Product

Resources

About