Improving specialty care follow-up after an ED visit using a unique referral system

Messina, Frank C.; McDaniel, Michele; Trammel, Adam C.; Ervin, Denise R.; Kozak, Mary Ann; Weaver, Christopher S.

doi:10.1016/j.ajem.2013.08.007

Cited by 33 publications

(44 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[5][6][7][8][9] Globally, there are many studies on the factors influencing referral. Given the perfection of the GP system and reasonable rate of downward referral in many developed countries, foreign studies concentrate more on factors influencing upward referral by focusing on five aspects -sociodemographic characteristics of patients, [10][11][12] financial situation of patients, 13 characteristics of healthcare institutions, 14 characteristics of doctors 13 15-17 and their perceptions of referral, 18 and medical insurance. 12 However, a study in China showed that 93.4% of patients and their families are unwilling to be referred from hospitals to CHSs.…”

Section: Introductionmentioning

confidence: 99%

“…[23][24][25][26][27] Unbalanced health resource allocation and relatively poor medical technology in CHSs (compared with hospitals) is another key factor impeding the implementation of downward referral. 12 23 28 29 Although the development of CHSs is improving, current progress cannot completely balance health resource allocation and improve medical technology in CHSs, leaving much room for improvement. In 2012, the number of beds in hospitals (4 160 000) was 20 times that in CHSs (203 200), the number of medical staff in hospitals (4 057 640) was 10.48 times that in CHSs (386 952) and the number of hospital outpatient visits (2541 000 000) was 3.24 times that in CHSs (566 000 000).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Nong

et al. 2017

BMJ Open

View full text Add to dashboard Cite

ObjectivesIn China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics.MethodsDoctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling. The questionnaire surveyed their sociodemographic characteristics, attitudes towards CHSs and hospitals, understanding of downward referral, recognition of the community first treatment system, and downward referral practices and willingness. Descriptive statistics, χ2 test and stepwise logistic regression analysis were employed for statistical analysis.ResultsOnly 20.8% (161/773) of doctors were willing to accept downward referrals, although this proportion was higher among patients (37.6%, 326/866). Doctors' willingness was influenced by education, understanding of downward referral, and perception of health resources in hospitals. Patients' willingness was influenced by marital status, economic factors and recognition of the community first treatment system. Well-educated doctors who do not consider downward referral would increase their workloads and those with a more comprehensive understanding of hospitals and downward referral process were more likely to make a downward referral decision. Single-injury patients fully recognising the community first treatment system were more willing to accept downward referral. Patients' willingness was significantly increased if downward referral was cost-saving. A better medical insurance system was another key factor for patients to accept downward referral decisions, especially for the floating population.ConclusionsTo increase the rate of downward referral, the Chinese government should optimise the current referral system and conduct universal publicity for downward referral. Doctors and patients should promote understandings of downward referral. Hospitals should realise the necessity of downward referral, effectively reduce workloads and provide continuing education for doctors. Increasing monetary reimbursement is urgent, as is improving the medical insurance system.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Nong

et al. 2017

BMJ Open

View full text Add to dashboard Cite

show abstract

“…It is our belief that close follow-up of patient status post-joint replacement is warranted for eliminating unnecessary medications, for medication reconciliation (especially with formulary differences) and management of pain, and for reducing the number of emergency department visits. Similar to expedited appointments for patients discharged from hospitals, 25 patients being discharged from SNFs need to have appointments expedited. Instructions should be given to office staff that patients being discharged from SNFs should be scheduled within 7 days of discharge, and for some patients it may be even sooner.…”

Section: Responsibilitiesmentioning

confidence: 99%

SGIM-AMDA-AGS Consensus Best Practice Recommendations for Transitioning Patients’ Healthcare from Skilled Nursing Facilities to the Community

et al. 2016

View full text Add to dashboard Cite

We assembled a cross-cutting team of experts representing primary care physicians (PCPs), home care physicians, physicians who see patients in skilled nursing facilities (SNF physicians), skilled nursing facility medical directors, human factors engineers, transitional care researchers, geriatricians, internists, family practitioners, and three major organizations: AMDA, SGIM, and AGS. This work was sponsored through a grant from the Association of Subspecialty Physicians (ASP). Members of the team mapped the process of discharging patients from a skilled nursing facility into the community and subsequent care of their outpatient PCP. Four areas of process improvement were identified, building on the prior work of the AMDA Transitions of Care Committee and the experiences of the team members. The team identified issues and developed best practices perceived as feasible for SNF physician and PCP practices to accomplish. The goal of these consensus-based recommended best practices is to provide a safe and high-quality transition for patients moving between the care of their SNF physician and PCP.

show abstract

“…Systems factors have also been implicated [1][2][3][4][5] . No-show rates can vary substantially by specialty 2,5,6 .…”

mentioning

confidence: 99%

“…Systems factors have also been implicated [1][2][3][4][5] . No-show rates can vary substantially by specialty 2,5,6 . Few studies, however, have investigated orthopaedic-specific factors related to no-show after an ED visit 2,7,8 .…”

mentioning

confidence: 99%

Injury Type and Emergency Department Management of Orthopaedic Patients Influences Follow-up Rates

Coleman

Medford‐Davis

Atassi

et al. 2014

The Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

This study supports previous evidence of high no-show rates with scheduled orthopaedic follow-up among patients treated in the ED. The data highlight distinct orthopaedic-related factors associated with nonattendance. These findings are useful in identifying patients at high risk for no-show to scheduled orthopaedic follow-up appointments and may influence disposition and management decisions for these patients.

show abstract

Improving specialty care follow-up after an ED visit using a unique referral system

Cited by 33 publications

References 30 publications

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

SGIM-AMDA-AGS Consensus Best Practice Recommendations for Transitioning Patients’ Healthcare from Skilled Nursing Facilities to the Community

Injury Type and Emergency Department Management of Orthopaedic Patients Influences Follow-up Rates

Contact Info

Product

Resources

About