Frederick M Chen1, George E Fryer, Thomas E Norris. 1. Department of Family Medicine, University of Washington, 4311 11th Avenue NE, Ste. 210, Seattle, WA 98195, USA. fchen@u.washington.edu
Abstract
OBJECTIVE: To examine the effect of patient characteristics and comorbidity on referrals in primary care. METHODS: Cross-sectional analysis of patient encounters and referrals during a 1-year period for a primary care network of 9 clinics. The analysis adjusted for the clustering effect of physicians and clinics on the data. RESULTS: 23,720 specialty referrals were generated from 251,240 patient encounters, resulting in a total referral rate of 9.4 referrals per 100 encounters. Age, gender, and certain comorbid conditions were significant predictors of referral for any given encounter. CONCLUSIONS: Patient characteristics and comorbidity are predictors of referral. Studies of primary care processes need to account for clustering of physicians and clinics in their research design.
OBJECTIVE: To examine the effect of patient characteristics and comorbidity on referrals in primary care. METHODS: Cross-sectional analysis of patient encounters and referrals during a 1-year period for a primary care network of 9 clinics. The analysis adjusted for the clustering effect of physicians and clinics on the data. RESULTS: 23,720 specialty referrals were generated from 251,240 patient encounters, resulting in a total referral rate of 9.4 referrals per 100 encounters. Age, gender, and certain comorbid conditions were significant predictors of referral for any given encounter. CONCLUSIONS:Patient characteristics and comorbidity are predictors of referral. Studies of primary care processes need to account for clustering of physicians and clinics in their research design.