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Showing papers on "Referral published in 1973"


Journal ArticleDOI
TL;DR: This study, which analyzed referral rates in terms of differential arrest rates by crime and by geographical areas, provides more substantial findings on the factors affecting competency referrals.
Abstract: Prior research has suggested that the competency referral has often been utilized for purposes other than evaluation of the defendant's mental competency to stand trial. This study, which analyzed referral rates in terms of differential arrest rates by crime and by geographical areas, provides more substantial findings on the factors affecting competency referrals. Proximity to evaluation facilities and knowledge concerning the use of competency evaluation laws were among the identified factors.

44 citations



Journal ArticleDOI
TL;DR: The authors found that most of the patients in their study did not make or keep their appointments at an outpatient clinic after being evaluated and referred, and only 40 of them had received some type of professional care one year later.
Abstract: The authors found that most of the patients in their study—98 out of 153—did not make or keep their appointments at an outpatient clinic after being evaluated and referred. One year later they were able to obtain information on 51 of these patients and found that 40 of them had received some type of professional care.

43 citations


Journal ArticleDOI
TL;DR: High status internists showed the most cohesive patterns of referral and low status the least, and the influence of social friendships, distance between offices, and hospital appointments, as well as the institutionalization of reciprocity, are discussed.
Abstract: Patterns of referral among internists in private practice are examined in terms of the rewards and costs perceived by physicians occupying different levels of professional status in the medical community. Referral patterns are highly related to professional status networks. High status internists showed the most cohesive patterns of referral and low status the least. Findings pertaining to the institutionalization of reciprocity, as well as the influence of social friendships, distance between offices, and hospital appointments are discussed. Policy implications and areas for further research are suggested.

43 citations


Journal ArticleDOI
TL;DR: The authors' clinical impression that many depressed patients are admitted to hospitals without having received adequate drug treatment as outpatients is confirmed and a larger study of the actual patterns of drug prescription is proposed to seek the causes of inadequate treatment.
Abstract: The authors' clinical impression that many depressed patients are admitted to hospitals without having received adequate drug treatment as outpatients was confirmed with a sample of 51 depressed patients. Of these, only 20 percent had received proper drug treatment before referral. The authors propose a larger study of the actual patterns of drug prescription to seek the causes of inadequate treatment.

39 citations


Journal ArticleDOI
TL;DR: It was concluded that there were unmet needs for physician services in Montreal prior to the introduction of comprehensive health insurance and that these were related to income levels.
Abstract: We report here the results of three surveys conducted during 1969-70 as part of the first phase of a before and after study of the introduction of comprehensive health insurance in the Montreal metropolitan area. 1. Household Survey. In a survey of a random sample of 6,000 households over a 12-month period, no direct relationship was found between family income and use of physician service. However, an adjustment of family income for family size and composition resulted in a direct relationship with higher income families receiving more services than the lower; this relationship was particularly strong for children. In an attempt to see if the higher volume of services in high income families reflected greater need, symptoms of disease thought to require physician care were studied. These were found to be about the same for children in various income groupings but more frequent among adults in lower income groups. It was concluded that there were unmet needs for physician services in Montreal prior to the introduction of comprehensive health insurance and that these were related to income levels. 2. Work of Physicians. Interviews with a random sample of 497 practicing doctors in Montreal, between October 1969 and May 1970, showed that the average working day ranged from 9.7 hours for general internists to 11.7 hours for psychiatrists. The number of patients seen, excluding telephone consultations, ranged from 70 patients per week for psychiatrists and to 140 patients per week for general practitioners. 3. Use of Emergency Rooms. Interviews were conducted with 1,766 patients who attended emergency rooms in six Montreal hospitals for reasons other than an accident within 24 hours and with 1,694 who attended outpatient departments in two hospitals. The majority (83 per cent) of the emergency room patients interviewed had non-urgent conditions. Of those attending the two outpatient departments, 61 per cent claimed this as their usual source of care, and 70 per cent came without referral by a physician. While 70 per cent thought that continuity of physician care was important, two thirds said they would prefer the outpatient department even if all medical care were free. These three surveys are being repeated in 1971-72 approximately one year after the introduction of comprehensive health insurance.

24 citations


Journal ArticleDOI
TL;DR: Both programs had significant preventive and therapeutic effects on boys but not on girls, and effects were immediate in the upper middle class families, delayed in the lower class families.
Abstract: In 30 classrooms randomly assigned to experimental conditions, effects on mothers' reports of behavior symptoms were compared for (a) a parent education program; (b) an in-school program of consultation, counseling, training, and referral; and (c) control classrooms. A sample of 426 families were followed for 30 months from the child's entry into third grade. A simple unweighted count of the number of symptoms reported in a home interview had adequate validity, good reliability, low reactivity, and intrinsic significance. Both programs had significant preventive and therapeutic effects on boys but not on girls. Effects were immediate in the upper middle class families, delayed in the lower class families.

23 citations


Journal ArticleDOI
TL;DR: The present study attempts to answer the following questions about patients referred to the psychiatric outpatient department of a provincial teaching hospital.
Abstract: A survey of G.P.s referring patients, and of patients attending the psychiatric out-patient department suggests that approximately half the patients are referred for a diagnostic opinion or investigations, and a third for the hospital to take over management of the patient. It seems quite dear that between one third and one half of family doctors are using the out-patients as a source of primary care or advice, without first treating or investigating their patients. Some doctors use the clinic in this way because they regard the psychiatrist as having more time to interview the patient or relatives. There is also some reason to suspect that the more recently qualified doctors tend to refer more cases to the hospital, and prefer the hospital doctors to supervise their future management. The importance of influences other than the family doctor in the referral of a patient is emphasized. On the whole the expectation of the patients from treatment was low and in most cases realistic, but a minority of patients attended the out-patient department with the sole expectation of social help rather than with any emotional or psychiatric distress.

20 citations



Journal ArticleDOI
TL;DR: It is found that short-term psychiatric care is consistently associated with a decrease in the utilization of ancillary and medical services within the group practice setting.
Abstract: Group practice has emerged during the past decade as a major organizational form for the delivery of health care. Psychiatry, however, has been found to be the least inclined of the larger medical specialties toward participation in such groups. The authors compare data on diagnosis and referral patterns from several groups. They found that short-term psychiatric care is consistently associated with a decrease in the utilization of ancillary and medical services within the group practice setting.

15 citations


Journal ArticleDOI
TL;DR: Responses to a written questionnaire by family physicians and pediatricians in private practice concerning their evaluation and management of suspected childhood urinary tract infections have been compared to standards employed by a university pediatric department, which include documentation by culture, radiographic evaluation, and treatment.
Abstract: Responses to a written questionnaire by family physicians and pediatricians in private practice concerning their evaluation and management of suspected childhood urinary tract infections have been compared to the standards employed by a university pediatric department, which include documentation by culture, radiographic evaluation, and treatment. The survey reveals that 50% of physicians who responded made this diagnosis without cultures in the office setting. Criteria for ordering radiographic studies, choice of antibiotics, and indications for referral to a urologist differed from the standards. The implications of failure to discover correctable genitourinary abnormalities and of unnecessary drug or hospital utilization, and the place of peer review and continuing medical education in the private practice setting are discussed.

Journal ArticleDOI
TL;DR: In outpatient or ambulatory settings, the key decisions are made about investigation, therapy, referral and hospitalization, and the major opportunities occur for health maintenance, prevention, early detection and amelioration, as well as for initiating studies of the natural history of disease.
Abstract: Despite the top-heavy emphasis on hospital inpatient care in this country, the vast majority of transactions between our profession and the population we serve occur in outpatient or ambulatory settings. Patients enter the "system" via physicians' offices and clinics. Here, the key decisions are made about investigation, therapy, referral and hospitalization, and the major opportunities occur for health maintenance, prevention, early detection and amelioration, as well as for initiating studies of the natural history of disease.1 Patients do not seek help for categorically labeled diseases; they present themselves to physicians with symptoms, complaints and problems. These are the language of . . .

Journal ArticleDOI
TL;DR: Two demographically comparable samples, each with 108 primary graders seen by nonprofessional child aides for school maladaptation problems, were compared on initial status (referral) and change-in-status (outcome) measures, finding Ts to be significantly less maladjusted on referral and to have shown greater program improvement as judged by teacher and aide judges.
Abstract: Two demographically comparable samples, each with 108 primary graders seen by nonprofessional child aides for school maladaptation problems, were compared on initial status (referral) and change-in-status (outcome) measures. A terminator (T) group included youngsters judged to have made sufficienl progress to be able to dispense with program help. Nonterminators (NTs) were those for whom a similar judgment could not be made. Ts were found to be significantly less maladjusted on referral and to have shown greater program improvement as judged by teacher and aide judges. Outcome differences between groups remained, even after referral differences favoring Ts were partialed out.


Journal ArticleDOI
TL;DR: In this paper, the authors discuss the attrition at Referral among Heroin Addicts in the context of the International Journal of the Addictions: Vol. 8, No. 5, pp. 839-846.
Abstract: (1973). Attrition at Referral Among Heroin Addicts. International Journal of the Addictions: Vol. 8, No. 5, pp. 839-846.

Journal ArticleDOI
TL;DR: A program for information and referral services is presented which has two primary purposes: facilitating client access to human services and obtaining data for the planning of human services.
Abstract: The historical development of information and referral services is presented, along with an analysis of the activities in which agencies identifying them- selves as information and referral centers are currently engaged. From this perspective, a program for information and referral services is presented which has two primary purposes: facilitating client access to human services and obtaining data for the planning of human services. The strengths and limitations of this program are discussed in terms of its role in bringing about coordination of human services. It is suggested that present-day information and referral services may simply be a transitional service in the development of a centralized intake, assessment, and referral agency.


Journal ArticleDOI
TL;DR: In this article, a follow-up study was conducted to determine the outcome of 254 referrals made by 47 school psychologists in New York and New Jersey, which represented randomly selected cases in which the recommendation was made to the families of elementary school childred to use service external to the school setting.

Journal ArticleDOI
TL;DR: Children participating in an 8-wk.
Abstract: Summary.-Children participating in an 8-wk. clinic program focused on neuromotor perceptual training were compared with waiting-list controls for changes in physical activity level, verbal activity level, dependency, and aggression. Increased activity levels were expected in association with peers and clinic staff and decreased activity levels in association with a "mother-busy" sirnation. Of 15 significant effects obtained 12 were in the hypothesized directions. The results provide empirical evidence of previous anecdotal reports of the parents and teachers of the clinic participants. Research and treatment programs conducted by Delacato ( 1963 ) , Cratcy (1969), and the present writers (Fretz, Johnson, & Johnson, 1969) have demonstrated the significant role of neuromotor perceptual training for improved intellectual and cognitive functioning as well as improved perceptual motor skills. Such empirical evidence of improved skill functioning has been welcomed by referral persons such as pediatricians and reading specialists. Parents and teachers, however, often report being more impressed by behavioral changes such as activity levels and personal-social adjustment. The present study was designed to investigate empirically the behavioral changes which are most frequently reported by parents and teachers. The four categories selected for investigation were physical activity level, verbal activity level, dependency, and aggression. Each of these categories, except verbal activity level, has been utilized in other developmental research and, whereever possible, scales were utilized which could be assessed not only for reliability but also for their relationships to existing developmental data. Reports from clinical personnel, as well as parents and teachers, suggested the need for behavioral assessment of the children in diverse relationships. The three most apparent contrasting relationships were with a peer, with a clinic staff member, and with the mother. With peer and clinician the child was in essentially an unstructused situation; with the mother, the session was set up as a "mother-busy" situation in order to appraise the child's behavior when he was with the mother yet responsible for "amusing" himself. The following hypotheses were tested wirh respect to preclinic to postclinic changes: (1) clinic participants' physical activity and verbal activity levels will increase significantly more than waiting-list controls' in the peer and clinician situations, (2) clinic participants' physical activity and verbal activity levels will decrease significantly more than the waiting-list controls' in the "mother-busy"


Journal ArticleDOI
TL;DR: The Massachusetts Mental Health Centre was influenced by both the Amsterdam Municipal Programme and the Worthing Experiment, and attempted to prevent hospitalisation by providing outpatient care foi patients awaiting admission to the hospital.
Abstract: to decrease psychiatric admissions. As a result of domiciliary visits plus active outpatient treatment, hospital admissions fell drastically. The Massachusetts Mental Health Centre3 was influenced by both the Amsterdam Municipal Programme and the Worthing Experiment, and attempted to prevent hospitalisation by providing outpatient care foi patients awaiting admission to the hospital. Home visits were a significant part of the process. In 1957 the Boston State Hospital created a home treatment programme for patients. Their experience is presented in the book, Home Treatment4. Four


Journal ArticleDOI
TL;DR: In this article, the authors evaluated patients newly referred to a pediatric cardiology clinic and found that approximately two thirds of the children did not have heart disease, while the other third had significant heart disease and 77% had congenital malformations.
Abstract: Evaluation of patients newly referred to a pediatric cardiology clinic revealed that approximately twothirds of the children did not have heart disease. Of the other third, those with significant heart disease, 77% had congenital malformations and most were in the first year of life when diagnosed. Those in the first month of life had the highest mortality rate. Among newly referred school-aged children rheumatic heart disease was the major diagnosis. Screening constituted a high proportion of the service9s work load. Pediatricians did not differ significantly from other referral sources in the preselection for referral of cardiac cases. The annual incidence of pediatric heart disease was comparable for different geographic areas surrounding the medical center and for racial groups. However, significant differences were found in the circumstances leading to referral. In disadvantaged black children, referral depended principally on hospital clinics visited for noncardiac illness. White children were predominantly referred in the course of routine examinations performed by pediatricians. The findings reveal a need to plan specialty services in relation to the population base and with consideration of the accessibility and performance of the professionals who will select the patients for referral.

Journal ArticleDOI
TL;DR: A brief survey of the organisation in the United Kingdom of existing facilities for rehabilitation, training and sheltered employment precedes a description of five years work in a voluntary, non-profit making organisation (Bristol Industrial Therapy Organisation) as mentioned in this paper.
Abstract: A brief survey of the organisation in the United Kingdom of existing facilities for rehabilitation, training and sheltered employment precedes a description of five years work in a voluntary, non-profit making organisation (Bristol Industrial Therapy Organisation (Bristol) Limited). The classification of patients referred during this period is reported and the outcome of attendance. The success and failure, according to sources of referral and diagnosis, is commented on and a two-year follow-up is given. A summary of outcome for the first eleven years of the Organisation is recorded. — The present state of industrial therapy is discussed and the need for research and for workers in the field to become more highly specialised is stressed. — The change in clientele is noted with an increase in referral of patients suffering from subnormality. A likely increase in persons with personality disorders is anticipated. — The different methods of approach by I. T. O. to the problem of reemployment are enumerated and the applicability of the I. T. O. principle to other groups, for example, ex-prisoners, prisoners, physically handicapped, etc. is suggested. The strength accruing to the Organisation from close links with the hospital and community is noted and the Organisations view that there should not be separate rehabilitation services for the psychiatrically ill and for the physically ill is stated. The continuation of voluntary organisations such as I. T. O. is considered desirable but not in the continuous provision of services which are clearly the responsibility of statutory authorities. These authorities must give fresh thought to the problem of providing services appropriate to modern needs.

Journal ArticleDOI
TL;DR: The purpose of this survey was to assist in determining the compatibility of existing HIRS and the feasibility of linking these services into one computerized health services data system for Los Angeles County.
Abstract: Information and referral services provide a vital link in the delivery of health care in the United States today. However, relatively little is known about the exact nature of these services.1'2 At the University of Southern California School of Medicine, a research and development project, known as "SEARCH: A Link to Services," has been concerned with health information and referral services (HIRS) in Los Angeles County. This project has been exploring the feasibility of a comprehensive and integrated data system designed to supply providers with up-to-date information about sources of health care tailored to meet the individual needs of the consumers (clients and patients) whom they serve. It is expected that such a system will expedite the referral process, thereby enabling more consumers within the county to reach appropriate sources of health care. The survey reported here was conducted as part of the larger SEARCH project. The purpose of this survey was to assist in determining the compatibility of existing HIRS and the feasibility of linking these services into one computerized health services data system for Los Angeles County. The objective of the survey was to answer the following question: What are the characteristics of existing HIRS within Los Angeles County? These services are defined as those which:

Journal Article
TL;DR: A trial program in 12 Georgia counties in which caseworkers from the Department of Family and Children Services participated in a distribution program with their clients working cooperatively through the County Health Departments which made available supplies of foam and condoms indicated that this can be a successful approach in outreach and referral to medical resources.
Abstract: It was with supporting interest that I read the editorial "Non-Medical Birth Control - a Neglected and Promising Field" (June 1973). This idea was of special significance because I had helped to plan and implement a trial program in 12 Georgia counties in which caseworkers from the Department of Family and Children Services participated in a distribution program with their clients working cooperatively through the County Health Departments which made available supplies of foam and condoms. The results of this 3-month experience (July-September 1972) indicated that this can be a successful approach in outreach and referral to medical resources. Of those contacted 1/3 rejected the offer and of this 1/3 almost 50% had previously used a method. 2/3 of the group contacted accepted the offer of free supplies and subsequent clinic appointments and of this group accepting 75% had never before used a method. In addition to the advantages for clients the caseworkers recognized benefits in terms of the opportunity to inform to counsel to prepare clients for the clinic visit and to assist with plans to accept and utilize medical care for family planning as well as other County Health Department services. We would agree and endorse this as 1 way of increasing the nonclinical delivery of services.(FULL TEXT)

Journal ArticleDOI
TL;DR: In this article, a pilot comprehensive prepaid health care plan was developed to provide a working model for the teaching and improved delivery of pediatric health care in a university teaching hospital, where house staff and fellows functioned as primary physicians to their own panel of patients.

Journal ArticleDOI
TL;DR: The authors describe the consultation sessions, some of the cases dealt with, and the major areas on which consultation focused, and emphasize the importance of flexibility in the consultative process so the needs of consultees will not be overlooked.
Abstract: Police officers in a special unit designed to aid troubled children and adolescents requested mental health consultation after a series of frustrations in their attempts to refer cases to psychiatric agencies. The officers initially sought guidelines to help them determine which clients needed further care and select appropriate agencies for referral. As the meetings progressed it became apparent that what they needed most was help with their interviewing techniques. The authors describe the consultation sessions, some of the cases dealt with, and the major areas on which consultation focused. They emphasize the importance of flexibility in the consultative process so the needs of consultees will not be overlooked.

Journal ArticleDOI
TL;DR: This paper focuses on the common aberrant disorders in language de velopment, rather than on productive disorders such as cleft palate, voice disorders, misarticulations or nonfluencies ("stuttering").
Abstract: The child who uses delayed or disordered language, particularly when he may be doing somewhat better in other areas of his development, presents difficult questions concerning both identification and direction of referral. This paper focuses on the common aberrant disorders in language de velopment, rather than on productive disorders such as cleft palate, voice disorders, misarticulations or nonfluencies ("stuttering"). Guide lines for consultation with a communication specialist are presented.