Studies have shown large variation of referral probabilities in different countries, and many influencing factors have been described. This variation is most likely explained by different healthcare systems, particularly to which extent primary care physicians (PCPs) act as gatekeepers. In Switzerland no mandatory gatekeeping system exists, however insurance companies offer voluntary managed ca...

BACKGROUND Outcomes for colorectal cancer patients vary significantly. Compared to other countries, Australia has a good record with patient outcomes, yet there is little information available on the referral pathway. This paper explores the views of Australian patients and their experiences of referral for colorectal cancer treatment following diagnosis; the aim was to improve our understandin...

The emergency department (ED) represents an important transition of care for patients, where understanding the patient health condition is critical to forming an appropriate plan of care. Because many emergency referral visits are unplanned and urgent, this information may not be conveyed in advance to ED physicians. Loss of this data can lead to costly over-testing in the ED referral, or worse...

INTRODUCTION Within China's multi-tiered medical system, many patients seek care in higher-tiered hospitals without a referral by a primary-care provider. This trend, generally referred to as patient self-referral behavior, may reduce the efficiency of the health care system. This study seeks to test the hypothesis that having a usual primary care provider could reduce patients' self-referral b...

BACKGROUND No literature exists which examines referral preferences to, or the consultation process with, Otolaryngology. In a recent Canadian Medical Association nation-wide survey of General Practitioners and Family Physicians, Otolaryngology was listed as the second-most problematic specialty for referrals. The purpose of this study was to learn about and improve upon the referral process be...

BACKGROUND Fetal alcohol spectrum disorder (FASD) is known to be under-recognised in Australia. The use of standard methods to identify when to refer individuals who may have FASD for specialist assessment could help improve the identification of this disorder. The purpose of this study was to develop referral criteria for use in Australia. METHOD An online survey about FASD screening and dia...

Exercise-based cardiac rehabilitation (CR) programs have been a part of the secondary prevention landscape for more than 50 years. Multiple controlled trials and meta-analyses have confirmed its proven benefits with regard to mortality and, to a lesser extent, morbidity. Due to the strong evidence supporting its role in secondary prevention, CR is recognized as a class I recommendation. Despite...

BACKGROUND Referral for both lifestyle and surgical interventions are recommended as part of the clinical management of obesity in general practice. However, current practice falls short of this. This qualitative study aimed to describe the factors influencing general practitioners' (GPs) referral intentions for their obese patients. METHODS Semi-structured qualitative interviews were conduct...

INTRODUCTION Electronic health records (EHRs) are receiving a lot of attention for their potential to improve care. OBJECTIVE To develop and implement EHRs in the antenatal clinic (ANC) of a teaching and referral hospital in Western Kenya. RESULTS A multidisciplinary team developed a phased implementation of EHRs in the ANC as part of a CDC-funded effort to develop and implement primary car...

OBJECTIVE The Portland [Maine] Identification and Early Referral (PIER) program was established in 2000 as a prevention system for identifying and treating youths at high risk of an initial psychotic episode. METHODS During six years, 7,270 professionals from the educational, medical, and mental health sectors were provided information on prodromal symptoms and means for rapid referral of at-...