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J Am Board Fam Pract. 2005 Nov-Dec;18(6):449-52.

Effects of comorbidity and clustering upon referrals in primary care.

Author information

1
Department of Family Medicine, University of Washington, 4311 11th Avenue NE, Ste. 210, Seattle, WA 98195, USA. fchen@u.washington.edu

Abstract

OBJECTIVE:

To examine the effect of patient characteristics and comorbidity on referrals in primary care.

METHODS:

Cross-sectional analysis of patient encounters and referrals during a 1-year period for a primary care network of 9 clinics. The analysis adjusted for the clustering effect of physicians and clinics on the data.

RESULTS:

23,720 specialty referrals were generated from 251,240 patient encounters, resulting in a total referral rate of 9.4 referrals per 100 encounters. Age, gender, and certain comorbid conditions were significant predictors of referral for any given encounter.

CONCLUSIONS:

Patient characteristics and comorbidity are predictors of referral. Studies of primary care processes need to account for clustering of physicians and clinics in their research design.

PMID:
16322407
[Indexed for MEDLINE]
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