BACKGROUND Few clinical trials have evaluated interventions for major depressive disorder in samples of low-income minority women, and little is known about the cost-effectiveness of depression interventions for this population. OBJECTIVE To evaluate the cost-effectiveness of pharmacotherapy or cognitive behavior therapy (CBT) compared with community referral for major depression in low-incom...

BACKGROUND Electronic referral (eReferral) from community into public secondary healthcare services was introduced to 30 referring general medical practices and 28 hospital based services in late 2007. OBJECTIVES To measure the extent of uptake of eReferral and its association with changes in referral processing. METHODS Analysis of transactional data from the eReferral message service and ...

BACKGROUND In many countries, the referral-consultation process faces a number of challenges from inefficiencies and rising demand, resulting in excessive wait times for many specialties. We collected referral data from a sample of family doctors across the province of Ontario, Canada as part of a larger program of research. The purpose of this study is to describe referral patterns from primar...

This study examined the influence of a direct referral process implemented by a population-based provincial breast screening program on the time from screening to first procedure, first procedure to diagnosis, and screening to diagnosis following an abnormal breast screening result. The direct referral process shifted the responsibility for the coordination of diagnostic follow-up procedures fr...

BACKGROUND Early patient referral correlates with improved patient survival on dialysis. We examine whether early referral and a planned first dialysis affect quality of life (QoL). METHODS All patients commencing dialysis in nine centres in seven European countries between 1 July 1998 and 31 October 1999 were recruited. DEFINITIONS early referral=followed by a nephrologist >1 month before ...

BACKGROUND Late diagnosis contributes to the UK having poorer cancer survival than many countries in Europe. Cancer referral guidelines help GPs decide which patients to refer urgently for further investigation. AIM To examine primary care referral patterns, compliance with referral guidance, and eventual outcome for patients. DESIGN AND SETTING Prospective audit within general practice in ...

BACKGROUND Although children are frequently referred to specialists, detailed information on referral patterns of them is scarce. Even less information is available on how referral patterns evolve over time. AIMS To examine current referral patterns for children aged 0-17 years and compare these with referral patterns reported for 1987. DESIGN OF STUDY Data were analysed from two national c...

BACKGROUND Joint consultations - such as teleconsultations - provide opportunities for continuing education of general practitioners (GPs). It has been reported this form of interactive case-based learning may lead to fewer GP referrals, yet these studies have relied on expert opinion and simple frequencies, without accounting for other factors known to influence referrals. We use a survey-base...

BACKGROUND Patients with late referral and positive history of volume overload may have a poor prognosis after initiating dialysis due to insufficient and/or inadequate management of complications of renal failure and the lack of better dialysis preparation. Little is known about the influence of the relationship between history of volume overload and late referral on prognosis. METHODS We an...

BACKGROUND The objective of this study was to evaluate the cost-effectiveness of centralized referral of patients with advanced-stage epithelial ovarian cancer who underwent primary cytoreductive surgery and adjuvant chemotherapy. METHODS A decision-analysis model was used to compare 2 referral strategies for patients with advanced-stage ovarian cancer: 1) referral to an expert center, with a...