BACKGROUND/AIMS: To evaluate a guideline selecting patients at the primary care level for referral to a specialist, to identify bottlenecks and subsequently implement and evaluate improvements. METHODS: Retrospective patient files analysis and a prospective cohort study. The study was conducted in Municipal Public Health Service (PHS), University Medical Center. Patients diagnosed with chronic hepatitis B virus (HBV) infection were referred to the PHS. Improvement of bottlenecks were identified in the referral chain, based on the guideline. Number of patients receiving correct advice, number of patients reaching the hospital for specialist care, time between notification of the PHS and final arrival in the hospital. RESULTS: The guideline for the referral of chronic HBV patients appeared to be appropriate, although one-third of the selected patients was not seen by the specialist. After the intervention more HBV patients (76 versus 61%) received correct advice from the PHS, and the number of HBV patients seen by the specialist increased by 18%. CONCLUSIONS: The referral guideline works, yet we could improve the efficiency of the guideline increasing the proportion of eligible patients reaching specialist care. In countries where mandatory reporting of HBV infections exists this guideline can be adapted to local health systems.
BACKGROUND/AIMS: To evaluate a guideline selecting patients at the primary care level for referral to a specialist, to identify bottlenecks and subsequently implement and evaluate improvements. METHODS: Retrospective patient files analysis and a prospective cohort study. The study was conducted in Municipal Public Health Service (PHS), University Medical Center. Patients diagnosed with chronic hepatitis B virus (HBV) infection were referred to the PHS. Improvement of bottlenecks were identified in the referral chain, based on the guideline. Number of patients receiving correct advice, number of patients reaching the hospital for specialist care, time between notification of the PHS and final arrival in the hospital. RESULTS: The guideline for the referral of chronic HBVpatients appeared to be appropriate, although one-third of the selected patients was not seen by the specialist. After the intervention more HBVpatients (76 versus 61%) received correct advice from the PHS, and the number of HBVpatients seen by the specialist increased by 18%. CONCLUSIONS: The referral guideline works, yet we could improve the efficiency of the guideline increasing the proportion of eligible patients reaching specialist care. In countries where mandatory reporting of HBV infections exists this guideline can be adapted to local health systems.
Authors: Irene K Veldhuijzen; Marijke C Mostert; Hubert G M Niesters; Jan Hendrik Richardus; Robert A de Man Journal: Gut Date: 2007-07 Impact factor: 23.059
Authors: Monica C Robotin; Melanie Q Kansil; Jacob George; Kirsten Howard; Steven Tipper; Miriam Levy; Nghi Phung; Andrew G Penman Journal: BMC Health Serv Res Date: 2010-07-21 Impact factor: 2.655
Authors: Daniel T Myran; Rachael Morton; Beverly-Ann Biggs; Irene Veldhuijzen; Francesco Castelli; Anh Tran; Lukas P Staub; Eric Agbata; Prinon Rahman; Manish Pareek; Teymur Noori; Kevin Pottie Journal: Int J Environ Res Public Health Date: 2018-09-01 Impact factor: 3.390