General practitioner referrals to paediatric specialist outpatient clinics: referral goals and parental influence
Marina Kunin 1 , Erin Turbitt 1 , Sarah A. Gafforini 1 , Lena A. Sanci 2 , Neil A. Spike 2 , Gary L. Freed 11 Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
2 General Practice and Primary Health Care Academic Centre, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
Correspondence to: Gary L. Freed, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Vic. 3053, Australia. Email: gary.freed@unimelb.edu.au
Journal of Primary Health Care 10(1) 76-80 https://doi.org/10.1071/HC17030
Published: 29 March 2018
Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Previous research on general practitioner (GP) referrals in adult populations demonstrated that patient pressure influenced referral practice. No research has been conducted to investigate how involvement of a parent influences paediatric referrals.
AIM: To investigate whether GPs who report parental influence on their decision to refer paediatric patients differ in their referral patterns from GPs who do not report parental influence.
METHOD: A mail survey of 400 GPs who had referred at least two children to paediatric specialist outpatient clinics during 2014 was distributed.
RESULTS: The response rate was 67% (n = 254). For initial referrals, 27% of GPs stated that parental request frequently or almost always influenced their referral decision. For returning referrals, 63% of GPs experienced parental influence to renew a referral because a paediatrician wanted a child to return; 49% of GPs experienced influence to renew a referral because a parent wanted to continue care with a paediatrician. Experiencing parental influence was associated with increased likelihood for frequent referrals in order for a paediatrician to take over management of a child’s condition.
DISCUSSION: GPs who frequently refer with a goal for a paediatrician to take over management of a child’s condition also report that parental request almost always influences their decision to refer.
KEYWORDS: Primary care; secondary care; outpatients; child care; continuity of patient care; delivery of health care
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