Role of school-based health centers in referral completion

Hacker, Karen; Weintraub, Toni Abrams; Fried, Lise E.; Ashba, Jacqueline

doi:10.1016/s1054-139x(97)00045-1

Cited by 16 publications

(7 citation statements)

References 13 publications

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“…Scheduling the appointment with the specialist at the time the referral was made had a strong positive effect on referral completion. Other researchers have found a similar association between assistance in scheduling the specialist's appointment and referral completion for youth referred from school-based health centers, 5 patients referred from an emergency department to outpatient psychiatry, 14 and patients referred for mammograms. 15 Staff or physician scheduling of the specialty referral appointment is low-cost, practical, and, as this study shows, an important determinant of referral completion.…”

Section: Discussionmentioning

confidence: 63%

“…Based on chart audits and physician survey, prior studies have found that 63% to 82% of patients referred from primary care settings ultimately attend a consultation with the type of specialist to whom they were referred. [4][5][6] Beyond these descriptive estimates, there is little information on the associations among patient, referring physician, and health care delivery system characteristics with referral completion.…”

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confidence: 99%

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Specialty Referral Completion Among Primary Care Patients: Results From the ASPN Referral Study

Forrest¹,

Shadmi²,

Nutting³

et al. 2007

The Annals of Family Medicine

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PURPOSE This study describes referral completion from the perspectives of patients and primary care physicians and identifi es predictors of adherence to the referral recommendation. METHODSWe observed a cohort of 776 referred patients from the offi ces of 133 physicians in 81 practices and 30 states. Referring physicians and patients completed self-administered questionnaires at the time of the referral decision and 3 months later.RESULTS Physicians reported that 79.2% of patients referred had a specialist visit, and 83.0% of patients indicated they completed the referral. The most common reasons for not completing the referral were "lack of time" and patient belief that the "health problem had resolved." The κ statistic for patient-physician agreement on referral completion was 0.34, indicating only fair concordance. Patients in Medicaid plans were less likely than others to complete the referral, and more likely to experience a health plan denial. A longer duration of the patient relationship with the primary care physician and physician/staff scheduling of the specialty appointment were both positive predictors of referral completion. CONCLUSIONS About 8 in 10 patients referred from primary care complete a specialty referral within 3 months. Findings from this study suggest that referral completion rates may be increased by assisting patients with scheduling their specialty appointments and promoting continuity of care.

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Section: Discussionmentioning

confidence: 63%

mentioning

confidence: 99%

Specialty Referral Completion Among Primary Care Patients: Results From the ASPN Referral Study

Forrest¹,

Shadmi²,

Nutting³

et al. 2007

The Annals of Family Medicine

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“…Patients aged 0–17 years, or their parents, and patients aged 65 years and older more often complied, which was not found in studies from the United States [ 3 , 17 – 19 ]. A reason for the differences in referral compliance with age could lay in the compulsory deductible which is not in operation for patients aged 0–17 years.…”

Section: Discussionmentioning

confidence: 71%

Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study

Dijk¹,

Jong²,

Verheij³

et al. 2016

BMC Fam Pract

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BackgroundIn a gatekeeper system, primary care physicians and patients jointly decide whether or not medical specialist care is needed. However, it is the patient who decides to actually use the referral. Referral non-compliance could delay diagnosis and treatment. The objective of this study was to assess patient compliance with a referral to medical specialist care and identify patient and practice characteristics that are associated with it.MethodsObservational study using data on 48,784 referrals to medical specialist care derived from electronic medical records of 58 general practices for the period 2008–2010. Referral compliance was based on claims data of medical specialist care. Logistic multilevel regression analyses were conducted to determine associations between patient and general practice characteristics and referral compliance.ResultsIn 86.6 % of the referrals, patients complied. Patient and not practice characteristics were significantly associated with compliance. Patients from deprived urban areas and patients aged 18–44 years were less likely to comply, whereas patients aged 65 years and older were more likely to comply.ConclusionAbout 1 in 8 patients do not use their referral. These patients may not receive adequate care. Demographic and socio-economic factors appear to affect compliance. The results of this study may be used to make general practitioners more aware that some patients are more likely to be noncompliant with referrals.

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“…However, it should be noted that only a fraction of the referral recommendations result in a visit (Bourguet et al , 1998; Byrd and Moskowitz, 1987; Forrest et al , 2007; Hacker et al , 1997; Wu et al , 1996). Let R be the event that the specialist receives a referral visit and RM be the event that a referral to a specialist is made by another physician.…”

Section: Methodsmentioning

confidence: 99%

The effect of medical malpractice liability on rate of referrals received by specialist physicians

Spurr

Nan

et al. 2013

HEPL

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Using nationally representative data from the U.S., this paper analyzed the effect of a state’s medical malpractice environment on referral visits received by specialist physicians. The analytic sample included 12,839 ambulatory visits to specialist care doctors in office-based settings in the U.S. during 2003–2007. Whether the patient was referred for the visit was examined for its association with the state’s malpractice environment, assessed by the frequency and severity of paid medical malpractice claims, medical malpractice insurance premiums, and an indicator for whether the state had a cap on noneconomic damages. After accounting for potential confounders such as economic or professional incentives within practices, the analysis showed that statutory caps on noneconomic damages of $250,000 were significantly associated with lower likelihood of a specialist receiving referrals, suggesting a potential impact of a state’s medical malpractice environment on physicians’ referral behavior.

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Role of school-based health centers in referral completion

Cited by 16 publications

References 13 publications

Specialty Referral Completion Among Primary Care Patients: Results From the ASPN Referral Study

Specialty Referral Completion Among Primary Care Patients: Results From the ASPN Referral Study

Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study

The effect of medical malpractice liability on rate of referrals received by specialist physicians

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