Aristithes G Doumouras1,2, Sama Anvari2, Ruth Breau3, Mehran Anvari1,2, Dennis Hong1,2, Scott Gmora4,5. 1. Department of Surgery, McMaster University, Hamilton, ON, Canada. 2. Division of General Surgery, St. Joseph's Healthcare, Room G836, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada. 3. Centre for Surgical Invention and Innovation, Hamilton, ON, Canada. 4. Department of Surgery, McMaster University, Hamilton, ON, Canada. gmora@mcmaster.ca. 5. Division of General Surgery, St. Joseph's Healthcare, Room G836, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada. gmora@mcmaster.ca.
Abstract
BACKGROUND: The Ontario Bariatric Network implemented an online referral system to completely replace a fax-based system in 2015. Strategies such as electronic information transfer have been suggested to improve the bariatric referral process but few studies exist demonstrating their efficacy. Therefore, the purpose of this study was to determine the impact on referral rates to bariatric surgery after converting to an online referral system from a fax-based system. METHODS: All referrals from 2011 to 2015 were included in the study. The main outcomes included the total number of referrals and whether a practitioner increased referrals after the implementation of the online referral system. A hierarchical logistic regression model was used for the final analysis. Predictors of interest included physician and neighbourhood level factors RESULTS: Referrals more than doubled overall and increased significantly across all health regions. Compared to practitioners in their first five years, all other experience groups were approximately 50% less likely to increase referrals. Compared to those within 50 km of a bariatric facility, practitioners 50-99 km (OR 0.76 95% CI 0.58-0.98 p = 0.04) and 100-199 km (OR 0.73 95% CI 0.55-0.96 p = 0.03) away were both significantly less likely to increase referrals. CONCLUSION: This study found that referrals increased significantly after implementing an online referral system. Furthermore, physicians in their first five years of practice as well as those practicing closer to bariatric centers were more likely to increase referrals. Our findings demonstrate that an online referral system may aid in increasing referrals to bariatric surgery.
BACKGROUND: The Ontario Bariatric Network implemented an online referral system to completely replace a fax-based system in 2015. Strategies such as electronic information transfer have been suggested to improve the bariatric referral process but few studies exist demonstrating their efficacy. Therefore, the purpose of this study was to determine the impact on referral rates to bariatric surgery after converting to an online referral system from a fax-based system. METHODS: All referrals from 2011 to 2015 were included in the study. The main outcomes included the total number of referrals and whether a practitioner increased referrals after the implementation of the online referral system. A hierarchical logistic regression model was used for the final analysis. Predictors of interest included physician and neighbourhood level factors RESULTS: Referrals more than doubled overall and increased significantly across all health regions. Compared to practitioners in their first five years, all other experience groups were approximately 50% less likely to increase referrals. Compared to those within 50 km of a bariatric facility, practitioners 50-99 km (OR 0.76 95% CI 0.58-0.98 p = 0.04) and 100-199 km (OR 0.73 95% CI 0.55-0.96 p = 0.03) away were both significantly less likely to increase referrals. CONCLUSION: This study found that referrals increased significantly after implementing an online referral system. Furthermore, physicians in their first five years of practice as well as those practicing closer to bariatric centers were more likely to increase referrals. Our findings demonstrate that an online referral system may aid in increasing referrals to bariatric surgery.
Keywords:
Bariatric surgery; Online referral system; Primary care referrals
Authors: David B Sarwer; Scott Ritter; Thomas A Wadden; Jacqueline C Spitzer; Marion L Vetter; Reneé H Moore Journal: Surg Obes Relat Dis Date: 2012-01-30 Impact factor: 4.734
Authors: Mark Auspitz; Michelle C Cleghorn; Arash Azin; Sanjeev Sockalingam; Fayez A Quereshy; Allan Okrainec; Timothy D Jackson Journal: Obes Surg Date: 2016-09 Impact factor: 4.129
Authors: Nicolas V Christou; John S Sampalis; Moishe Liberman; Didier Look; Stephane Auger; Alexander P H McLean; Lloyd D MacLean Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: Richard Welbourn; John Dixon; Julian H Barth; Nicholas Finer; Carly A Hughes; Carel W le Roux; John Wass Journal: Obes Surg Date: 2016-03 Impact factor: 4.129