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BMC Primary Care
Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study

Authors: Christel E. van Dijk, Judith D. de Jong, Robert A. Verheij, Tessa Jansen, Joke C. Korevaar, Dinny H. de Bakker

Published in: BMC Primary Care | Issue 1/2016

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Abstract

Background

In a gatekeeper system, primary care physicians and patients jointly decide whether or not medical specialist care is needed. However, it is the patient who decides to actually use the referral. Referral non-compliance could delay diagnosis and treatment. The objective of this study was to assess patient compliance with a referral to medical specialist care and identify patient and practice characteristics that are associated with it.

Methods

Observational study using data on 48,784 referrals to medical specialist care derived from electronic medical records of 58 general practices for the period 2008–2010. Referral compliance was based on claims data of medical specialist care. Logistic multilevel regression analyses were conducted to determine associations between patient and general practice characteristics and referral compliance.

Results

In 86.6 % of the referrals, patients complied. Patient and not practice characteristics were significantly associated with compliance. Patients from deprived urban areas and patients aged 18–44 years were less likely to comply, whereas patients aged 65 years and older were more likely to comply.

Conclusion

About 1 in 8 patients do not use their referral. These patients may not receive adequate care. Demographic and socio-economic factors appear to affect compliance. The results of this study may be used to make general practitioners more aware that some patients are more likely to be noncompliant with referrals.
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Metadata
Title
Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study
Authors
Christel E. van Dijk
Judith D. de Jong
Robert A. Verheij
Tessa Jansen
Joke C. Korevaar
Dinny H. de Bakker
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0401-7

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