» Articles » PMID: 15527611

Dutch General Practitioners' Referral of Children to Specialists: a Comparison Between 1987 and 2001

Overview
Journal Br J Gen Pract
Specialty Public Health
Date 2004 Nov 6
PMID 15527611
Citations 4
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Although children are frequently referred to specialists, detailed information on referral patterns of them is scarce. Even less information is available on how referral patterns evolve over time.

Aims: To examine current referral patterns for children aged 0-17 years and compare these with referral patterns reported for 1987.

Design Of Study: Data were analysed from two national cross-sectional surveys, performed in 2001 (91 general practices) and in 1987 (103 general practices).

Setting: Dutch general practice.

Method: All new referrals to specialists were assessed by age, sex, International Classification of Primary Care (ICPC) category, specialty referred to, and specific episodes of disease. Referral measures were quantified as new referrals per 1000 person-years and per 100 new episodes, a measure of likelihood of a young person with a specific diagnosis to be referred. Rates in 2001 were compared with those from 1987.

Results: Referral rates decreased from 138 per 1000 person-years in 1987, to 84 per 1000 person-years in 2001. Age differences in referral rates were similar in both surveys. Compared with 1987, more boys than girls were referred to specialists. The overall likelihood of a condition being referred decreased from 8.0 per 100 episodes in 1987 to 6.5 per 100 episodes in 2001. Reasons for referral had also changed by 2001, particularly for the ear, nose, and throat (ENT) specialist and ophthalmologist. Moreover, referral rates for acute otitis media, refractive disorders, and vision problems decreased two- to fourfold in 2001.

Conclusion: Presently, Dutch general practitioners tend to manage more health problems themselves and refer less young people to specialists.

Citing Articles

The role of area level social deprivation on childhood and adolescent consultation rate in primary care: a population based, cohort study.

Fonderson M, Bindels P, Bohnen A, de Schepper E BMC Prim Care. 2022; 23(1):270.

PMID: 36303141 PMC: 9613447. DOI: 10.1186/s12875-022-01873-x.


To which non-physician health professionals do French general practitioners refer their patients to and what factors are associated with these referrals? Secondary analysis of the French national cross-sectional ECOGEN study.

Peurois M, Chopin M, Texier-Legendre G, Angoulvant C, Bellanger W, Begue C BMC Health Serv Res. 2022; 22(1):25.

PMID: 34983505 PMC: 8729109. DOI: 10.1186/s12913-021-07285-4.


ENT problems in Dutch children: trends in incidence rates, antibiotic prescribing and referrals 2002-2008.

Uijen J, Bindels P, Schellevis F, van der Wouden J Scand J Prim Health Care. 2011; 29(2):75-9.

PMID: 21591837 PMC: 3347949. DOI: 10.3109/02813432.2011.569140.


Decreasing incidence of adenotonsillar problems in Dutch general practice: real or artefact?.

Biermans M, Theuns-Lamers E, Spreeuwenberg P, Verheij R, van der Wouden J, de Vries Robbe P Br J Gen Pract. 2010; 59(569):e368-75.

PMID: 20875250 PMC: 2784551. DOI: 10.3399/bjgp09X473141.

References
1.
Forrest C, Reid R . Prevalence of health problems and primary care physicians' specialty referral decisions. J Fam Pract. 2001; 50(5):427-32. View

2.
Grol R . Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001; 39(8 Suppl 2):II46-54. DOI: 10.1097/00005650-200108002-00003. View

3.
Vehvilainen A, Kumpusalo E, TAKALA J . Reasons for referral from general practice in Finland. Scand J Prim Health Care. 1997; 15(1):43-7. DOI: 10.3109/02813439709043429. View

4.
Delnoij D, de Bakker D . Self-referral in a gatekeeping system: patients' reasons for skipping the general-practitioner. Health Policy. 1999; 45(3):221-38. DOI: 10.1016/s0168-8510(98)00045-1. View

5.
Westert G, Schellevis F, de Bakker D, Groenewegen P, Bensing J, van der Zee J . Monitoring health inequalities through general practice: the Second Dutch National Survey of General Practice. Eur J Public Health. 2005; 15(1):59-65. DOI: 10.1093/eurpub/cki116. View