Effects of Comorbidity and Clustering upon Referrals in Primary Care

Article Figures & Data

Table 1.

Referral Rates by Patient Characteristics

	N	Percentage Referred	χ²	P Value
Age group			33.91	.001
Under 18	62,027	6.73
18 to 64	163,359	10.82
65+	25,854	7.24
Gender			8.02	.022
Female	152,269	9.11
Male	98,967	9.95
Race			62.81	0.002
White	169,020	9.86
African American	12,370	9.07
Latino	6,241	8.27
Asian	15,739	7.91
Unknown	17,312	9.24

Table 2.

Adjusted Diagnostic Group (ADG) Referral Rates and Odds Ratios for Referral Controlling for Age Group, Gender, and Race

ADG	Referral Rate	Odds Ratio	(95% C.I.)
Time limited
Minor	9.30	1.01	(0.96, 1.06)
Minor-primary infections	7.99^***	0.76	(0.71, 0.82)
Major	11.13^*	1.19	(1.07, 1.33)
Allergies	8.55	0.89	(0.77, 1.02)
Asthma	9.30	0.97	(0.87, 1.08)
Likely to recur
Discrete	8.21^*	0.85	(0.72, 1.01)
Discrete infections	11.13^***	1.24	(1.15, 1.33)
Progressive	8.19^**	0.86	(0.78, 0.94)
Chronic medical
Stable	8.97	0.97	(0.73, 1.31)
Unstable	10.30^*	1.10	(1.02, 1.18)
Chronic specialty
Stable-orthopedic	10.39	1.16	(1.00, 1.34)
Stable-ent	16.84^**	1.83	(1.35, 2.47)
Stable-eye	16.15^*	2.03	(1.29, 3.19)
Unstable-ent	13.33^*	1.41	(1.11, 1.78)
Unstable-eye	13.48^*	1.60	(1.08, 2.38)
Injuries/adverse effects
Minor	10.07	1.03	(0.93, 1.14)
Major	11.61^***	1.25	(1.14, 1.38)
Psychosocial
Time limited, not severe	11.82^**	1.29	(1.13, 1.48)
Persistent/recurrent-stable	10.20	0.99	(0.87, 1.11)
Persistent/recurrent-unstable	10.87^**	1.11	(0.99, 1.26)
Signs/symptoms
Minor	9.49	0.91	(0.82, 1.00)
Uncertain	9.98^*	1.12	(1.04, 1.21)
Signs/symptoms
Major	11.07^**	1.29	(1.18, 1.41)
Discretionary	10.22^*	1.14	(1.07, 1.22)
See and reassure prevention	11.99^***	1.31	(1.22, 1.40)
Administrative	10.33	1.10	(0.96, 1.25)
Malignancy	8.53^***	0.79	(0.72, 0.86)
Pregnancy	14.31^**	1.77	(1.43, 2.19)
Dental	7.87	0.73	(0.56, 0.95)