| Literature DB >> 28143436 |
Olav Thorsen1,2, Miriam Hartveit3,4, Jan Olav Johannessen5,6, Lars Fosse7, Geir Egil Eide3,8, Jörn Schulz9,10, Anders Bærheim3.
Abstract
Entities:
Year: 2017 PMID: 28143436 PMCID: PMC5286772 DOI: 10.1186/s12875-016-0572-2
Source DB: PubMed Journal: BMC Fam Pract ISSN: 1471-2296 Impact factor: 2.497
Norwegian general practitioners’ scores on statements about their referral process (A1-10) and data collected when actually referring to hospital (B1-6) during 1 month in 2014 (n = 57)
| Variables | Mean | SD | Median | Min | Max | |
|---|---|---|---|---|---|---|
| Statements on VAS 10 cm: 0 = strongly disagree, 10 = strongly agree) | ||||||
| A1. “I spend a lot of time and effort on referrals” | 5.3 | 2.0 | 5.2 | 0.5 | 9.8 | |
| A2. “I often feel that I don’t know enough about what is expected to make a good referral” | 3.2 | 2.1 | 2.5 | 0.0 | 10.0 | |
| A3. “I am often afraid to have the referral rejected from hospital” | 1.4 | 1.5 | 1.0 | 0.0 | 8.0 | |
| A4. “I am often afraid that the referral gives an impression of me not knowing enough about the actual medical problem” | 2.9 | 2.2 | 2.0 | 0.0 | 9.5 | |
| A5. “It is easy to get in contact with a hospital specialist for advice” | 4.9 | 2.3 | 5.0 | 1.0 | 9.0 | |
| A6. “Some referrals could have been avoided if I had got in contact with a hospital consultant when referring” | 5.8 | 3.0 | 6.5 | 0.0 | 10.0 | |
| A7. “I usually complete the referral during the consultation” | 4.6 | 3.3 | 5.0 | 0.0 | 10.0 | |
| A8. “The patient’s participation and opinion is important to me when I refer” | 6.2 | 1.9 | 6.3 | 2.0 | 9.5 | |
| A9. “The patient should see the referral or have a copy before it is sent” | 5.0 | 2.8 | 5.0 | 0.3 | 10.0 | |
| A10 “Giving the patient a copy of the referral will improve the quality” | 4.4 | 2.8 | 5.0 | 0.5 | 10.0 | |
| B1. Difficult referral to make | (Likert scale 1–10) | 2.6 | 1.0 | 2.7 | 1.0 | 5.6 |
| B2. Pressure from patient to be referred | (Likert scale 1–10) | 2.0 | 0.8 | 1.0 | 1.0 | 4.7 |
| B3. Suggesting a priority for the patient to be admitted to hospital (%) | 39.9 | 39.3 | 26.0 | 0.0 | 100.0 | |
| B4. Suggesting a wait for the patient to be admitted to hospital (%) | 28.2 | 33.6 | 17.6 | 0.0 | 100.0 | |
| B5. Telephone contact with hospital specialist when referring (%) | 9.1 | 16.1 | 0.0 | 0.0 | 100.0 | |
| B6. The time used for making the referral (minutes) | 8.2 | 3.5 | 7.5 | 2.0 | 17.1 | |
Abbreviations: GP: General practitioner; SD: standard deviation; VAS: visual analogue scale; Min: minimum, Max: maximum
Eigenvalues and cumulative variance of the first ten components in a principal component analysis of 16 variables of the referral process from 57 general practitioners in Norway during spring 2014
| Initial eigenvalues | |||
|---|---|---|---|
| Component | Total | % of variance | Cumulative % |
| 1 | 2.3 | 14.4 | 14.4 |
| 2 | 1.9 | 12.0 | 26.5 |
| 3 | 1.7 | 10.9 | 37.3 |
| 4 | 1.6 | 10.0 | 47.3 |
| 5 | 1.4 | 8.5 | 55.8 |
| 6 | 1.3 | 8.3 | 64.1 |
| 7 | 1.1 | 7.0 | 71.1 |
| 8 | 1.0a | 6.0 | 77.1 |
| 9 | 0.9 | 5.3 | 82.4 |
| 10 | 0.8 | 5.1 | 87.5 |
a)0.961
Rotated pattern matrix after principal component analysisa) of 16 variables of the referral process from 57 general practitioners in Norway during spring 2014
| Components | ||||||||
|---|---|---|---|---|---|---|---|---|
| Variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| A3: Afraid of rejection of referral |
| .052 |
| .031 |
| .124 | .038 |
|
| A4: Not being good enough |
|
|
|
|
| .021 |
| .020 |
| A2: Unknown expectations |
|
| .246 | .015 | .060 |
| .383 |
|
| B4: Suggested waiting |
|
| .252 | .150 |
|
|
|
|
| B3: Priority in referral |
|
|
| .028 | .370 | .157 | .056 | .030 |
| A1: Using much time to refer | .043 |
| - | .110 | .108 | .021 |
|
|
| A7: Referral in consultation |
|
|
| .062 |
| .111 |
|
|
| B5: Conferred with consultant | .026 |
| .103 | - | .056 | .097 |
| .147 |
| A8: Patient opinion important |
| .002 | .085 |
|
|
|
|
|
| A5: Contact with consultant |
| .021 |
| .080 |
| .041 |
| .373 |
| B6: Time used to refer | .043 | .027 |
|
| .027 |
| .124 |
|
| B1: Difficult referral | .152 | .091 | .083 | .351 | .006 |
|
| .279 |
| A6: Referral avoided if contact | .308 | .373 |
|
| .333 | - |
| .145 |
| A10: Copy gives better quality |
| .020 |
|
| .118 |
| - | .038 |
| A9: Referral copy to patient | .033 |
| .036 | .247 | .213 |
|
| - |
| B2: Patient pressure |
|
| .198 | .356 | .084 | .004 |
|
|
a)Using an oblique (oblimin) rotation with Kaiser normalisation. Loadings larger than 0.4 are highlighted
Results from multivariate multiple linear regression analysis of eight principal components on referrals from 57 general practitioners (GPs) in Norway in 2014
| Dependent variables: Typological components | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Independent variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | Multivariate |
| b ( | b ( | b ( | b ( | b ( | b ( | b ( | b ( |
| |
| GP age |
| 0.01 (0.780) | 0.01 (0.727) | 0.01 (0.904) | 0.01 (0.594) | 0.01 (0.580) | 0.02 (0.235) | −0.01 (0.791) | .965 |
| Gender: male | −0.23 (0.412) |
| 0.54 (0.068) | −0.22 (0.463) | 0.07 (0.815) | 0.57 (0.069) | 0.34 (0.254) |
|
|
| Specialty: no |
| −0.13 (0.822) | 0.79 (0.148) | 0.16 (0.770) | 0.08 (0.892) | 0.84 (0.146) | 0.83 (0.145) |
|
|
| Location: urban | −0.39 (0.214) | −0.12 (0.714) | −0.16 (0.624) | 0.48 (0.157) | −0.51 (0.138) | −0.45 (0.189) | −0.06 (0.860) | −0.12 (0.684) | .269 |
| N referrals | −0.01 (0.893) | 0.02 (0.346) | 0.04 (0.090) | 0.05 (0.049) | 0.01 (0.575) | 0.02 (0.519) | −0.03 (0.258) | 0.05 (0.020) | .056 |
b: Estimated regression coefficients; p-values from t-test