Referral Research Papers - Academia.edu (original) (raw)

Background: around the world health systems constantly face increasing pressures which arise from many factors, such as an ageing population, patients and providers demands for equipment’s and services. In order to respond these challenges and reduction of health system’s transactional costs, referral solutions are considered as a key factor. This study was carried out to identify referral solutions that have had successes. Methods:

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- Health Communication, Consultation, Medicine, Health System

The Projahnmo-II Project in Mirzapur upazila (sub-district), Tangail district, Bangladesh, is promoting care-seeking for sick newborns through health education of families, identification and referral of sick newborns in the community by community health workers (CHWs), and strengthening of neonatal care in Kumudini Hospital, Mirzapur. Data were drawn from records maintained by the CHWs, referral hospital registers, a baseline household survey of recently-delivered women conducted from March to June 2003, and two interim household surveys in January and September 2005. Increases were observed in self-referral of sick newborns for care, compliance after referral by the CHWs, and care-seeking from qualified providers and from the Kumudini Hospital, and decreases were observed in care-seeking from unqualified providers in the intervention arm. An active surveillance for illness by the CHWs in the home, education of families by them on recognition of danger signs and counselling to seek...

- by Nawshad Ahmed
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- Demography, Nutrition and Dietetics, Health Promotion, Health Education

Despite the increasing usage and popularity of chiropractic care, there has been limited research conducted to examine the professional relationships between conventional trained primary care physicians (PCPs) and chiropractors (DCs). The objectives of our study were to contrast the intra-professional referral patterns among PCPs with referral patterns to DCs, and to identify predictors of PCP referral to DCs. We mailed a survey instrument to all practicing PCPs in the state of Iowa. Descriptive statistics were used to summarize their responses. Multivariable logistic regression analyses were conducted to identify demographic factors associated with inter-professional referral behaviors. A total of 517 PCPs (33%) participated in the study. PCPs enjoyed strong intra-professional referral relationships with other PCPs. Although patients exhibited a great deal of interest in chiropractic care, PCPs were unlikely themselves to make formal referral relationships with DCs. PCPs in a priva...

Objective. To determine how well the current fluoride supplementation schedule was known by academic pediatricians and to examine the fluoride supplement prescribing and dental referral practices among primary care faculty pediatricians at four medical centers. Setting. Four university medical centers in North Carolina. Subjects. Primary care faculty pediatricians. Method. A questionnaire pretested for clarity was distributed to all identified full-time primary care pediatric faculty (42 members). Results. A total of 40 completed questionnaires were returned. Thirty-seven (93%) primary care faculty pediatricians reported that they routinely addressed the need for fluoride supplements for their patients, but only 28 (70%) determined the fluoride content of the drinking water before prescribing supplements. Thirty-five (87.5%) began supplements at the correct age, but fewer knew the correct doses for children of various ages. Only 23 (58%) referred their patients for oral examination ...

- by Michael Roberts
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- Dentistry, Pediatrics, Primary Health Care, Family Medicine

As funding for home-based palliative care continues to expand, there is an increasing need to understand barriers to patient referral to and acceptance of home-based palliative care. The aim of this study was to elicit perspectives of home-based palliative care administrators and providers on barriers encountered in identification, referral, and enrollment of patients eligible for home-based palliative care. We conducted a qualitative study employing focus groups of nine home-based palliative care agencies across California. Focus groups were audio-recorded and transcribed. Using thematic analysis, researchers independently coded the transcripts and identified themes from the codes. 25 HBPC staff participated in the nine focus groups. Participants included both clinicians (n=17) and administrators (n=8). Our analysis revealed 13 themes that fit under four major thematic categories: 1) lack of formal payment structures (few HBPC payors and variation in payment and services among payors), 2) agency structure barriers (limitations of electronic medical records and multiple lines of business), 3) patient- and family-level barriers (misconceptions/lack of palliative care knowledge, uninformed of the referral/ no warm hand-off, reluctance to have strangers in the home, overwhelmed with health issues and related services, HBPC service refusal/unresponsive to outreach), and 4) physician-level barriers (misconceptions/lack of palliative care knowledge, variability in HBPC payment and services, lack of time, patient ownership). HBPC providers identified a myriad of barriers that preclude patient access to HBPC. With growing provision of HBPC services, greater efforts to overcome these barriers are needed.

- by Alexis Coulourides Kogan
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- Nursing, Family Medicine, Palliative Care, Medicine

Introduction. Smoking cessation integration within lung cancer screening programs is challenging. Currently, phone counselling is available across Canada for individuals referred by healthcare workers and by self-referral. We compared quit rates after phone counselling interventions between participants who self-refer, those referred by healthcare workers, and those referred by a lung cancer screening program. Methods. This is a retrospective cohort study of participants referred to provincial smoking cessation quit line in contemporaneous cohorts: self-referred participants, healthcare worker referred, and those referred by a lung cancer screening program if they were still actively smoking at the time of first contact. Baseline, covariates (sociodemographic information, smoking history, and history of mental health disorder) and quit intentions (stage of change, readiness for change, previous use of quit programs, and previous quit attempts) were compared among the three cohorts. ...

- by Ankita Ghatak
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- Medicine, Smoking Cessation, Cohort, Lung cancer screening

Substance use remains a leading cause of preventable death globally. A model of intervention known as screening, brief intervention, and referral to treatment (SBIRT) was developed decades ago to facilitate time-and resource-sensitive interventions in acute care and outpatient settings. SBIRT, which includes a psychosocial intervention incorporating the principles of motivational interviewing, has been shown to be effective in reducing alcohol consumption and consequences in unhealthy drinkers both in primary care and emergency department settings. Subsequently, SBIRT for unhealthy alcohol use has been endorsed by governmental agencies and professional societies in multiple countries. Although most trials support the efficacy of SBIRT for unhealthy alcohol use (McQueen et al. in Cochrane Database Syst Rev 8, 2011; Kaner et al. in Cochrane Database Syst Rev 2, 2007; O'Donnell et al. in Alcohol Alcohol 49(1):66-78, 2014), results are heterogenous; negative studies exist. A newer approach to screening and intervention for substance use can incorporate initiation of medication management at the index visit, for individuals willing to do so, and for providers and healthcare systems that are appropriately trained and resourced. Our group has conducted two successful trials of an approach we call screening, treatment initiation, and referral (STIR). In one trial, initiation of nicotine pharmacotherapy coupled with screening and brief counseling in adult smokers resulted in sustained biochemically confirmed abstinence. In a second trial, initiation of buprenorphine for opioid dependent individuals resulted in greater engagement in treatment at 30 days and greater self-reported abstinence. STIR may offer a new, clinically effective approach to the treatment of substance use in clinical care settings.

- by Alexis Coulourides Kogan
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- Nursing, Family Medicine, Palliative Care, Medicine

Arts for health interventions are an accepted option for medical management of mental wellbeing in health care. Updated findings are presented from a prospective longitudinal follow-up (observational) design study of an arts on referral programme in UK general practice, over a 7-year period (2009-2016). Primary care process and mental wellbeing outcomes were investigated, including progress through the intervention, changes in mental wellbeing, and factors associated with those outcomes. A total of n = 1297 patients were referred to an eight or 10-week intervention over a period from 2009 to 2016. Patient sociodemographic information was recorded at baseline, and patient progress (e.g. attendance) assessed throughout the intervention. Of all referrals, 51.7% completed their course of prescribed art (the intervention). Of those that attended, 74.7% engaged with the intervention as rated by the artists leading the courses. A significant increase in wellbeing was observed from pre- to ...

- by Colin Baker
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- Primary Care, Family Medicine, Medicine, European Public Health Policies

Introduction : The Partograph is a tool that monitors active stages of labour. This enables skilled birth attendants, who are largely midwives, to monitor progress of labour, the mother and the fetus regularly. It provides a clear means of tracking labour progress with ‘alert’ and ‘action’ lines that signal when labour has become complicated. It helps in the management of labour by providing information to identify women who are or not likely to have a normal delivery. Objective: To assess partograph utilization among nurse-midwives in the maternity unit of Coast General Hospital, Mombasa. Methods: This was a descriptive study among midwives and nurse-midwives working in the Maternity unit of Coast general hospital, Mombasa. All 59 nurse-midwives who were working in the unit during the study period were included in the study with an eventual response rate of 86% (51). Data was collected using a self-administered semi- structured questionnaire. Qualitative data was cleaned, coded and...

- by jane karonjo
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- Medicine, Referral
- by Randall Eberts
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- Decision support system, service Business, Referral

IMPORTANCE Telehealth enables access to genetics clinicians, but impact on care coordination is unknown. OBJECTIVE To assess care coordination and equity of genetic care delivered by centralized telehealth and traditional genetic care models. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included patients referred for genetic consultation from 2010 to 2017 with 2 years of follow-up in the US Department of Veterans Affairs (VA) health care system. Patients were excluded if they were referred for research, cytogenetic, or infectious disease testing, or if their care model could not be determined. EXPOSURES Genetic care models, which included VA-telehealth (ie, a centralized team of genetic counselors serving VA facilities nationwide), VA-traditional (ie, a regional service by clinical geneticists and genetic counselors), and non-VA care (ie, community care purchased by the VA). MAIN OUTCOMES AND MEASURES Multivariate regression models were used to assess associations between patient and consultation characteristics and the type of genetic care model referral; consultation completion; and having 0, 1, or 2 or more cancer surveillance (eg, colonoscopy) and risk-reducing procedures (eg, bilateral mastectomy) within 2 years following referral. RESULTS In this study, 24 778 patients with genetics referrals were identified, including 12 671 women (51.1%), 13 193 patients aged 50 years or older (53.2%), 15 639 White patients (63.1%), and 15 438 patients with cancer-related referrals (62.3%). The VA-telehealth model received 14 580 of the 24 778 consultations (58.8%). Asian patients, American Indian or Alaskan Native patients, and Hawaiian or Pacific Islander patients were less likely to be referred to VA-telehealth than White patients (OR, 0.54; 95% CI, 0.35-0.84) compared with the VA-traditional model. Completing consultations was less likely with non-VA care than the VA-traditional model (OR, 0.45; 95% CI, 0.35-0.57); there were no differences in completing consultations between the VA models. Black patients were less likely to complete consultations than White patients (OR, 0.84; 95% CI, 0.76-0.93), but only if referred to the VA-telehealth model. Patients were more likely to have multiple cancer preventive procedures if they completed their consultations (OR, 1.55; 95% CI, 1.40-1.72) but only if their consultations were completed with the VA-traditional model. CONCLUSIONS AND RELEVANCE In this cross-sectional study, the VA-telehealth model was associated with improved access to genetics clinicians but also with exacerbated health care disparities and hindered care coordination. Addressing structural barriers and the needs and (continued) Key Points Question How is a centralized telehealth model associated with care coordination and equity of genetic services delivery? Findings In this national cross-sectional study of 24 778 adult patients with genetic referrals, certain racial and ethnic groups were significantly less likely to be referred to a centralized telehealth model than traditional genetic services, and completing consultations was significantly less likely for Black patients referred to the telehealth model. Patients were more likely to have multiple cancer preventive procedures if they completed their consultations but only if completed with traditional genetic services. Meaning These findings suggest that, while a centralized telehealth model may improve access to genetics clinicians, care coordination may be compromised, and health care disparities may be exacerbated compared with a traditional care model.

- by Catherine Coffinier
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- Family Medicine, Telehealth, Medicine, Referral

Background Pharmacists can play a key role in managing ailments through their primary roles of supplying over-the-counter (non-prescription) medicines and advice-giving. It must be ensured that pharmacy staff practise in an evidence-based, guideline-compliant manner. To achieve this, mystery shopping can be used as an intervention to assess and train pharmacy staff. Objective To determine if repeated student pharmacist mystery shopping with immediate feedback affected the outcome of scenarios requiring referral to a medical practitioner. To determine what, if any, factors may influence whether referral occurred. Setting Thirteen community pharmacies across metropolitan Sydney, Australia. Methods Sixty-one student pharmacist mystery shoppers visited 13 community pharmacies across metropolitan Sydney once weekly over nine weeks between March-October 2015 to conduct audio-recorded mystery shopping visits with assigned scenarios (asthma, dyspepsia, diarrhoea). Students returned to the p...

- by Rebekah Moles
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- Pharmacy, Family Medicine, Medicine, Clinical Pharmacy

This study examined the referral patterns of rural/remote primary care physicians (PCPs) as well as their needs and interests for further training in child/adolescent mental health. Surveys were mailed to Canadian rural/remote PCPs requesting participants' demographic information, training and qualifications, referral patterns, and identification of needs and interests for continuing medical education (CME). PCPs were most likely to refer to mental health programs, and excessive wait times are the most common deterrent. Major reasons for referral were to obtain recommendations regarding medications and assessing non-responsive patients. While PCPs expressed higher levels of confidence in making appropriate referrals, they were much less confident in their knowledge and skills in managing mental health problems. Professional development in child/adolescent psychiatry is a moderate or highly perceived CME need. Overall, attention deficit/hyperactivity disorder (ADHD) was the most ...

- by Don Duncan
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- Primary Care, Family Medicine, Medicine, Referral

Background The medical equipment is any instrument, appliance, material, or other articles, whether used alone or in combination including the software necessary for the purpose of diagnosis, prevention, monitoring, treatment, or alleviation of the disease. The importance of e cient utilization of medical equipment has been brought to full public attention. The association between hospital characteristics and utilization of medical equipment has received more attention for its complicated consequences on health care costs and quality. So, the study aimed to assess factors affecting e cient utilization of medical equipment at public referral hospitals in East Wollega zone, Oromia regional state. Methods The study was conducted at public referral hospitals in East Wollega, Oromia Regional National State, Ethiopia from July 30-August 30, 2021. Cross-sectional study design was conducted mixed with observation and document review. About 192 equipment were included in the study. The descriptive statics and Pearson Chi-square (χ2) were performed to identify association between each independent and dependent variables at p < 0.05 to declare level of signi cance. Results Using 95% con dence interval, the level of utilization coe cient was estimated to be 0.49(0.44-0.55). Accordingly, 111(57.8%) equipment were e ciently utilized whereas 81(41.2%) of the equipment were underutilized. The form in which the hospitals received (χ2 = 7.7.2; P = 0.005), regularly availability (χ2 = 19.30; P = 0.000), the equipment breakdown (χ2 = 11.57; P = 0.001), availability of adequate trained staffs operating the equipment (χ2 = 26.14; P = 0.000), performing preventive maintenance (χ2 = 91.54; P = 0.000), availability of adequate spare parts (χ2 = 32.36; P = 0.000), and availability accessories(consumables) (χ2 = 43.91; P = 0.000) were the statistically signi cant associated factors affecting e cient utilization of the equipment. Conclusion On average, the utilization coe cient of medical equipment in the study hospitals was low compared to other study ndings which indicated that about 42.2% of the equipment were ine ciently utilized. The signi cant associated factors that could affect the e cient utilization of the equipment were the form in which the hospital received, regularly availability of the equipment, the equipment breakdown, availability of trained staffs operating the equipment, performing preventive maintenance, availability of adequate

- by Dufera Rikitu
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- Public Health, Medical Equipment, Medicine, Referral

Background: Diabetes is a chronic metabolic disease with increasing prevalence globally. Glycemic control is the ultimate management goal possible through self-care activities predominantly patient-driven and enhanced by one’s knowledge. These consequently minimize associated adverse complications hence maintaining the quality of life among people with diabetes. Self-care knowledge and practice are globally found unsatisfying to control glycemia among many diabetic populations. There is a critical need to assess current knowledge and practice regarding self-care among diabetic people to control their diabetes. Methods: We conducted a hospital-based cross-sectional study on 228 participants who were living with diabetes for at least six months since diagnosis. A standard tool, adopted and modified to suit the setting was used; the self-report Diabetic Knowledge Test Questionnaire for self-care knowledge and a revised version of the Summary Diabetes Self-Care Activities Questionnair...

- by Mercy Mwanja
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- Family Medicine, Medicine, Diabetes mellitus, Hypoglycemia

Background: Parental preferences and attitudes strongly influence dentists' choices for managing children's behavior in clinics. This study aimed to assess parental attitudes toward two behavior management technique (BMTs)-nitrous oxide (N2O) sedation and/or protective passive stabilization by papoose board (PB)-before and after their children received dental treatment at two referral centers in Jeddah, Saudi Arabia. Methods: Participants were parents of healthy children who required dental treatment under N2O and/or PB over an 18-month period. Before and after dental treatment, parents answered a questionnaire on their attitudes toward BMTs used on their children. Parents were divided into three groups: Group 1 (parents of children who received N2O), Group 2 (parents of children who received PB), and Group 3 (parents of children who received both N2O and PB). Results: Out of the 132 parents who answered the questionnaire, 106 (80.3%) were in Group 1, 10 (7.6%) in Group 2, and 16 (12.1%) in Group 3. More children of parents with low monthly family incomes were in Group 3 than Group 1 compared to other family-incomes. Conclusion: Parental attitudes toward N2O and/or PB improved after their children experienced BMTs. The future use of PB alone with their child's sibling was parents' least preferred BMT (p = 0.001).

- by Heba Sabbagh
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- Dentistry, Cross sectional Study, Referral

Estimating the prevalence of SARS-CoV-2 antibody seropositivity among health care workers (HCWs) is crucial. In this study, the seroprevalence of anti-SARS-CoV-2 antibodies among HCWs of five hospitals of Tehran, Iran with high COVID-19 patient's referrals from April to June, 2020, was assessed. In this cross-sectional study, HCWs from three public and two private hospitals, selected randomly as a pilot, were included. Participants were asked questions on their demographic characteristics, medical history, hospital role, and usage of personal protective equipment (PPE). Iran FDA-approved SARS-CoV-2 ELISA kits were used to detect IgG and IgM antibodies in blood samples. The seroprevalence was estimated on the basis of ELISA test results and adjusted for test performance. Among the 2,065 participants, 1,825 (88.4%) and 240 (11.6%) HCWs were recruited from public and private hospitals, respectively. A total of 340 HCWs were tested positive for SARS-CoV-2-specific IgG or IgM antibod...

- by Fatemeh Shafighian
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- Family Medicine, Health Care, Public Health, Medicine

- by Catherine Coffinier
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- Family Medicine, Telehealth, Medicine, Referral
- by Andrew Rix
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- Primary Care, Urology, Primary Health Care, Family Practice

Background Inadequate monitoring and participant profiling have so far prevented a detailed examination of who Physical Activity Referral Schemes (PARS) are accessible to and appropriate for. As a result, the nature of the role for PARS within public health is unknown. Methods Participants were all those referred to a countywide PARS during a three-year period (n ¼ 3568). Participant age, gender and the deprivation level and rurality of their area of residence were compared with the average for the county population. Characteristics associated with referral uptake (attending 1 exercise session) and completion (80% attendance), were identified using logistic regression. Results Compared with the county average, participants were older, more predominantly female (61.1 vs 51.4%) and lived in more deprived areas (p , 0.001). Referral uptake (n ¼ 2864) was most likely in those aged 60-69 years, and least likely for residents of rural villages and the most deprived areas (all p , 0.001). For participants who took up referral, completion was most likely in men and the over-seventies (p , 0.001). Conclusions The PARS format may be inappropriate for younger adults or people living in relative deprivation and rural areas. They appear most appropriate for adults of middle-to-old age who are more likely to require supervision, and should be targeted accordingly.

- by Alex Smith
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- Health Promotion, Physical Activity, Public Health, Adolescent

Background: Each year 4.2 million people around the world die within 30 days of surgery and postoperative deaths account for 7.7 % of all deaths. So this study aimed to asses’ magnitude of postoperative mortality and associated factors among patients who underwent surgery in Wolaita Sodo University Teaching referral Hospital.Method: Retrospective cross sectional design was carried out from April 15-30 2019. Card review was done on 384 participants by using Systematic sampling technique. Entered to Epi Data; exported to SPSS for analysis. Variables with p-value < 0.25 in bivariate analysis were entered to multivariate logistic regression. Statistical significance is determined at p-value < 0.05.Results: The magnitude of postoperative mortality was 5.7%. Using surgical check list (AOR= 0.18; 95% CI 0.05 to 0.61), having comorbid condition (AOR= 4.45; 95% CI 1.39 to 14.19), and don’t having blood transfusion (AOR= 0.07; 95% CI 0.02 to 0.22) and general anesthesia (AOR= 4.37; 95% ...

- by Tiwabwork Tekalign
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- Medicine, Clinical Sciences, Referral

Efficacy of GP referral of insufficiently active al activity counseling: self-reported physical activity, sedentary behavior, quality of life, and depression. James et al. BMC Family Practice (2014) 15:218 DOI 10.1186/s12875-014-0218-1Callaghan, NSW, Australia Full list of author information is available at the end of the articleDiscussion: If referral of primary care patients to exercise specialists increases physical activity, this process offers the prospect of systematically and sustainably reaching a large proportion of insufficiently active adults. If shown to be efficacious this trial provides evidence to expand public funding beyond those with a chronic disease and for delivery via telephone as well as face-to-face consultations.

- by Charlotte Hespe
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- Primary Care, Physical Activity, Trial Registration, Referral