Journal
ANNALS OF FAMILY MEDICINE
Volume 5, Issue 4, Pages 361-367Publisher
ANNALS FAMILY MEDICINE
DOI: 10.1370/afm.703
Keywords
referral and consultation; appointment adherence; patient acceptance of health care; primary health care; practice-based research; delivery of health care; continuity of patient care
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PURPOSE This study describes referral completion from the perspectives of patients and primary care physicians and identifies predictors of adherence to the referral recommendation. METHODS We observed a cohort of 776 referred patients from the offices 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 K statistic for patient-physician agreement on referral completion was 0.34, indicating only fair concordance. Patients ans were less likely than others to complete the referral, and more in Medicaid pl. likely to experience a health plan denial. A longer duration of the patient relation- ship 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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