Gary L Freed1, Erin Turbitt, Marina Kunin, Sarah Gafforini, Lena Sanci, Neil Spike. 1. MD, MPH is Australian-American Health Policy Fellow, Australian Health Workforce Institute, University of Melbourne and Professor of Paediatrics and Child Health Policy, University of Michigan, United States of America.
Abstract
BACKGROUND: Changes in the demography of Australia have resulted in changes in patterns of primary care delivery. One of these changes is that the proportion of paediatric visits has decreased. OBJECTIVE: The objectives of the article are to examine patient, practice and personal factors that influence a general practitioner's (GP's) decision to refer patients for paediatric specialty care, and investigate referral goals and experience with shared care. METHODS: A mail survey was sent out to 400 GPs who had referred at least two children to public hospital specialty clinics during 2014. RESULTS: The response rate for the mail survey was 67%. The factors most commonly reported by GPs as 'Somewhat important' or 'Very important' in the decision to refer were whether they had enough knowledge of a specific condition (81%) or did not have experience with similar patients (75%). About one-quarter (26%) of GPs reported that a parental request 'Frequently' or 'Almost always' influenced their referral decision. A similar pro-portion (26%) placed importance on whether they had sufficient time for a specific patient. DISCUSSION: Understanding the perspectives and determinants of GP referrals for paediatric specialty care is important, especially in the context of changing patterns of primary care delivery.
BACKGROUND: Changes in the demography of Australia have resulted in changes in patterns of primary care delivery. One of these changes is that the proportion of paediatric visits has decreased. OBJECTIVE: The objectives of the article are to examine patient, practice and personal factors that influence a general practitioner's (GP's) decision to refer patients for paediatric specialty care, and investigate referral goals and experience with shared care. METHODS: A mail survey was sent out to 400 GPs who had referred at least two children to public hospital specialty clinics during 2014. RESULTS: The response rate for the mail survey was 67%. The factors most commonly reported by GPs as 'Somewhat important' or 'Very important' in the decision to refer were whether they had enough knowledge of a specific condition (81%) or did not have experience with similar patients (75%). About one-quarter (26%) of GPs reported that a parental request 'Frequently' or 'Almost always' influenced their referral decision. A similar pro-portion (26%) placed importance on whether they had sufficient time for a specific patient. DISCUSSION: Understanding the perspectives and determinants of GP referrals for paediatric specialty care is important, especially in the context of changing patterns of primary care delivery.