RT Journal Article
SR Electronic
T1 Effects of Comorbidity and Clustering upon Referrals in Primary Care
JF The Journal of the American Board of Family Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 449
OP 452
DO 10.3122/jabfm.18.6.449
VO 18
IS 6
A1 Chen, Frederick M.
A1 Fryer, George E.
A1 Norris, Thomas E.
YR 2005
UL http://www.jabfm.org/content/18/6/449.abstract
AB 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.