Abstract:
BACKGROUND:In many countries, the referral-consultation process faces a number of challenges from inefficiencies and rising demand, resulting in excessive wait times for many specialties. We collected referral data from a sample of family doctors across the province of Ontario, Canada as part of a larger program of research. The purpose of this study is to describe referral patterns from primary care to specialist and allied health services from the primary care perspective. METHODS:We conducted a prospective study of patient referral data submitted by primary care providers (PCP) from 20 clinics across Ontario between June 2014 and January 2016. Monthly referral volumes expressed as a total number of referrals to all medical and allied health professionals per month. For each referral, we also collected data on the specialty type, reason for referral, and whether the referral was for a procedure. RESULTS:PCPs submitted a median of 26 referrals per month (interquartile range 11.5 to 31.8). Of 9509 referrals eligible for analysis, 97.8% were directed to medical professionals and 2.2% to allied health professionals. 55% of medical referrals were directed to non-surgical specialties and 44.8% to surgical specialties. Medical referrals were for procedures in 30.8% of cases and non-procedural in 40.9%. Gastroenterology received the largest share (11.2%) of medical referrals, of which 62.3% were for colonoscopies. Psychology received the largest share (28.3%) of referrals to allied health professionals. CONCLUSION:We described patterns of patient referral from primary care to specialist and allied health services for 30 PCPs in 20 clinics across Ontario. Gastroenterology received the largest share of referrals, nearly two-thirds of which were for colonoscopies. Future studies should explore the use of virtual care to help manage non-procedural referrals and examine the impact that procedural referrals have on wait times for gastroenterology.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Liddy C,Arbab-Tafti S,Moroz I,Keely Edoi
10.1186/s12875-017-0654-9subject
Has Abstractpub_date
2017-08-22 00:00:00pages
81issue
1issn
1471-2296pii
10.1186/s12875-017-0654-9journal_volume
18pub_type
杂志文章abstract:BACKGROUND:To investigate the current practice of Orthopaedic Surgeons & General Practitioners (GP) when presented with patients who have a fracture, with possible underlying Osteoporosis. METHODS:Questionnaires were sent to 140 GPs and 140 Orthopaedic Surgeons. The participants were asked their routine clinical pract...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-7-7
更新日期:2006-02-07 00:00:00
abstract:BACKGROUND:Late diagnosis is considered to be a major factor contributing to poorer cancer survival rates in the UK. Interventions have focussed on the promotion of earlier diagnosis in patients with potential cancer symptoms. However, to assess the effectiveness of these interventions, the time from symptom onset to p...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0167-8
更新日期:2014-10-25 00:00:00
abstract:BACKGROUND:The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcar...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-110
更新日期:2014-06-05 00:00:00
abstract:BACKGROUND:Depression is a major health concern, predominantly treated by general practitioners (GPs). Problem solving therapy (PST) is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. M...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-24
更新日期:2007-04-25 00:00:00
abstract:BACKGROUND:Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0224-y
更新日期:2015-01-29 00:00:00
abstract:BACKGROUND:Policy efforts focus on a reorientation of health care systems towards primary prevention. To guide such efforts, we analyzed the role of primary prevention in general practice and general practitioners' (GPs) attitudes toward primary prevention. METHODS:Mixed-method study including a cross-sectional survey...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-103
更新日期:2014-05-25 00:00:00
abstract:BACKGROUND:The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9) involved the development of a new survey instrume...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-57
更新日期:2009-08-22 00:00:00
abstract:BACKGROUND:The impact of caring for a family member or friend is a life changing experience. Often carers are struggling to cope with ongoing demands of caring for someone. At some point, most carers will approach their family physician for advice on aspects of their role. Carers Western Australia sought information an...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-7-33
更新日期:2006-05-24 00:00:00
abstract:BACKGROUND:Switzerland is facing a shortage of primary care physicians (PCPs); government organizations therefore suggested a broad variety of interventions to promote primary care. The aim of the study was to prioritize these interventions according to the acceptance and perceived barriers of most relevant groups of p...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0397-4
更新日期:2015-12-15 00:00:00
abstract:BACKGROUND:Standardised generic patient-reported outcome measures (PROMs) which measure health status are often unresponsive to change in primary care. Alternative formats, which have been used to increase responsiveness, include individualised PROMs (in which respondents specify the outcomes of interest in their own w...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0850-2
更新日期:2018-09-27 00:00:00
abstract:BACKGROUND:'Ad hoc' help-seeking by trainees from their supervisors during trainee consultations is important for patient safety, and trainee professional development. We explored trainee objectives and activities in seeking supervisor assistance, and trainee perceptions of the outcomes of this help-seeking (including ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1084-7
更新日期:2020-02-07 00:00:00
abstract:BACKGROUND:Families of children with rare diseases (i.e., not more than 5 out of 10,000 people are affected) are often highly burdened with fears, insecurities and concerns regarding the affected child and its siblings. Although families caring for children with rare diseases are known to be at risk for mental disorder...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01312-9
更新日期:2020-11-20 00:00:00
abstract:BACKGROUND:The benefit of a "diagnosis" of pre-diabetes in very elderly patients is debated. How clinicians manage pre-diabetic blood results in these patients is unknown. This study aims to understand how clinicians are "diagnosing" older patients with pre-diabetic blood parameters. METHODS:Semi-structured interviews...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0981-0
更新日期:2019-06-29 00:00:00
abstract:BACKGROUND:An open, constructive safety culture is key in healthcare since it is seen as a main condition for patient safety. Studies have examined culture improvement strategies in hospitals. In primary care, however, not much is known about effective strategies to improve the safety culture yet. The purpose of this s...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2296-14-127
更新日期:2013-08-29 00:00:00
abstract:BACKGROUND:The current reality of primary care (PC) makes it essential to have telemedicine systems available to facilitate communication between care levels. Communities of practice have great potential in terms of care and education, and that is why the Online Communication Tool between Primary and Hospital Care was ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0739-0
更新日期:2018-05-09 00:00:00
abstract:BACKGROUND:There are a substantial number of instruments for primary-care clinicians to assess physical-activity (PA). However, there are few studies that have explored the views of clinicians regarding comparative acceptability and ease of use. A better understanding of how clinicians perceive instruments could help o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0536-6
更新日期:2016-09-22 00:00:00
abstract:BACKGROUND:The vast majority of patients with diabetes have multiple chronic conditions, increasing complexity of care; however, clinical practice guidelines, interventions, and public reporting metrics do not adequately address the interaction of these multiple conditions. To advance the understanding of diabetes clin...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0253-6
更新日期:2015-03-28 00:00:00
abstract:BACKGROUND:The increasing number of available point-of-care (POC) tests challenges clinicians regarding decisions on which tests to use, how to efficiently use them, and how to interpret the results. Although POC tests may offer benefits in terms of low turn-around-time, improved patient's satisfaction, and health outc...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0893-4
更新日期:2019-01-10 00:00:00
abstract:BACKGROUND:Prognosis has been described as an important but neglected branch of clinical science. While patients' views have been sought in the context of life-threatening illness, similar research is lacking for patients presenting with common, non-life-threatening musculoskeletal complaints. The aim of this study was...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-50
更新日期:2009-07-07 00:00:00
abstract:BACKGROUND:Intimate partner violence (IPV) including physical, sexual and emotional violence, causes short and long term ill-health. Brief questions that reliably identify women experiencing IPV who present in clinical settings are a pre-requisite for an appropriate response from health services to this substantial pub...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-49
更新日期:2007-08-29 00:00:00
abstract:BACKGROUND:People who are diagnosed with both mental and chronic medical illness present unique challenges for the health care system. In resource-limited settings, such as rural India, people with depression and anxiety are often under-served, due to both stigma and lack of trained providers and resources. These chall...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-018-0845-z
更新日期:2018-09-11 00:00:00
abstract:BACKGROUND:Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appoin...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-11-79
更新日期:2010-10-25 00:00:00
abstract:BACKGROUND:Hallingdal is a rural region in southern Norway. General practitioners (GPs) refer acutely somatically ill patients to any of three levels of care: municipal nursing homes, the regional community hospital or the local general hospital. The objective of this paper is to describe the patterns of referrals to t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-87
更新日期:2013-06-22 00:00:00
abstract:BACKGROUND:A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mo...
journal_title:BMC family practice
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12875-015-0314-x
更新日期:2015-08-19 00:00:00
abstract:BACKGROUND:Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, a...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0693-2
更新日期:2018-01-12 00:00:00
abstract:BACKGROUND:General practitioners (GPs) often lack time and resources to invest in health education; audiovisual messages broadcast in the waiting room may be a useful educational tool. This work was designed to assess the effect of a message inviting patients to ask for a tetanus booster vaccination. METHODS:A quasi e...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-104
更新日期:2011-09-28 00:00:00
abstract:BACKGROUND:The relationship between effective organisation of general practices and health improvement is widely accepted. The Maturity Matrix is an instrument designed to assess organisational development in general practice settings and to stimulate quality improvement. It is undertaken by a practice team with the ai...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-7-38
更新日期:2006-06-19 00:00:00
abstract:BACKGROUND:Ultrasound imaging is utilized in Swiss primary care; however, little is known regarding the extent to which it is performed. With this study, we aim to (1) provide an overview of ultrasound use by general practitioners (GPs), and (2) determine the clinical indications of ultrasound in Swiss general practice...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01209-7
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Māori men in New Zealand have higher mortality from prostate cancer, despite having lower incidence rates. The objective of this study was to examine patterns of screening for prostate cancer in primary care and follow-up investigations after an elevated prostate-specific antigen (PSA) result in Māori and no...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-145
更新日期:2014-08-26 00:00:00
abstract:BACKGROUND:Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0773-y
更新日期:2018-06-19 00:00:00