Referral of patients to specialists: Factors affecting choice of specialist by primary care physicians
Referral of patients to specialists: Factors affecting choice of specialist by primary care physicians
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DOI：
10.1370/afm.68
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发表时间：
2004-05-01
影响因子：
4.4
通讯作者：
Powe, NR
中科院分区：
文献类型：
--
作者：
Kinchen, KS;Cooper, LA;Powe, NR
背景我们想确定的重要性因素在初级保健医生的选择专家时，指病人和比较医生的种族和sex.METHODS的重要性评级，我们调查了一个分层的国家样本的1,252初级保健医生为成年人服务，包括同等数量的黑人女性，白色女性，黑人男性和白色男性。我们评估了17个项目中的每一个的医生评级的百分比是在选择一个专家和比较医生的种族和性别的重要性rating。医疗技能，预约的及时性，保险范围，以前的经验与专家，专家沟通的质量，专家的努力，以返回患者的初级医生的照顾，以及良好的患者专家关系的可能性是最重要的受访者。与黑人医生相比，白色医生更倾向于认为以前的专家经验（65%对55%，P = 0.05）和委员会认证（41%对29%，P <0.05）是非常重要的。白色医生比黑人医生（17%比26%，P = 0.06）更不可能将患者的便利性视为主要重要性。与男性医生相比，女性医生更有可能将患者的保险状况评为非常重要（60%对44%，P < .01）。结论：为成人服务的初级保健医生在选择专科医生时考虑几个因素非常重要。患者的便利性，以前的经验与专家，专家委员会认证，并接受由专家的保险范围的重要性不同的医生的种族和性别。更好地了解对多样化医生队伍重要的因素可能有助于改善转诊过程。
BACKGROUND We wanted to determine the importance of factors in primary care physicians' choice of specialist when referring patients and to compare importance ratings by physicians' race and sex.METHODS Using a cross-sectional study design, we surveyed a stratified national sample of 1,252 primary care physicians serving adults to include equal numbers of black women, white women, black men, and white men. We assessed the percentage of physicians rating each of 17 items to be of major importance in choosing a specialist and compared importance ratings by physicians' race and sex.RESULTS The response rate was 59.1%. Medical skill, appointment timeliness, insurance coverage, previous experience with the specialist, quality of specialist communication, specialist efforts to return patient to primary physician for care, and the likelihood of good patient-specialist rapport were of major importance to most respondents. Compared with black physicians, white physicians were more likely to rate previous experience with the specialist (65% vs 55%, P = .05) and board certification (41% vs 29%, P < .05) to be of major importance. White physicians were somewhat less likely than black physicians (17% vs 26%, P = .06) to rate patient convenience to be of major importance. Compared with male physicians, female physicians were more likely to rate the patient's insurance status to be of major importance (60% vs 44%, P < .01).CONCLUSIONS Primary care physicians serving adults consider several factors to be of major importance when choosing a specialist. The importance of patient convenience, previous experience with the specialist, specialist board certification, and insurance coverage accepted by specialist varied by physicians' race and sex. A better understanding of factors important to a diverse physician workforce may help to improve the referral process.