scispace - formally typeset
Search or ask a question
Topic

Referral

About: Referral is a research topic. Over the lifetime, 27614 publications have been published within this topic receiving 479918 citations.


Papers
More filters
Journal ArticleDOI
TL;DR: Indicator scales for major health and social problems of individuals aged 65 or over who live in the community are developed to be comprehensive with regard to the CARE, to be relatively independent of one another, and to have satisfactory content, clinical, and face validities, and interrater and internal consistency reliabilities.
Abstract: The objective of this research was to develop indicator scales for major health and social problems of individuals aged 65 or over who live in the community. A semistructured interview technique, the Comprehensive Assessment and Referral Evaluation (CARE), was used in two large surveys in London and New York City. Twenty-two indicator scales were developed by using items that met certain clinical and statistical criteria. These indicator scales are intended for use in developing a general taxonomy of the problems of older individuals, for clinical assessment and referral of such individuals, and for use in geriatric epidemiological research. The scales were developed to be comprehensive with regard to the CARE, to be relatively independent of one another, and to have satisfactory content, clinical, and face validities, and interrater and internal consistency reliabilities.

129 citations

Journal ArticleDOI
TL;DR: Careful analysis revealed that because of their high referral scores, high perceived expertise, and reach to nearly all segments of the population, PCPs are in a unique position compared with dietitians and the FNEB.

129 citations

Journal ArticleDOI
TL;DR: Primary care physicians should refer patients at risk for ESRD earlier than is current practice, and greater collaboration will be needed between primary care physicians and nephrologists to improve access to transplantation.

129 citations

Journal ArticleDOI
TL;DR: Use of guidelines resulted in changes in dietitian practices and produced greater improvements in patient blood glucose outcomes at 3 months compared with usual care, and patient satisfaction with care and perceptions about quality of life.
Abstract: Objectives Assess the acceptance and ease of use of Nutrition Practice Guidelines for Type 1 Diabetes Mellitus by dietitians in a variety of settings; determine if nutrition care activities of dietitians change when practice guidelines are available; measure changes in patient control of blood glucose level, measured as glycated hemoglobin (HbA 1c ); compare patient satisfaction with care and perceptions about quality of life. Design Using the approach of outcomes research, volunteer dietitians were recruited and assigned randomly to a usual care group or a practice guidelines group. Patients with type 1 diabetes were enrolled by dietitians and followed up for a 3-month period. Outcome measures included dietitian care activities, changes in patient HbA 1c levels, and patient satisfaction and perceptions about quality of life. Subjects/settings Dietitians from across the United States who responded to a recruitment notice participated. Their work settings included diabetes referral centers, endocrinology clinics, primary care and community health clinics, hospitals, and a worksite clinic. They recruited patients from their setting for the study. Outcome data were available from dietitians providing care to 24 patients using the new practice guidelines and dietitians providing care to 30 patients using more traditional methods. Statistical analysis χ 2 Test, t test, and analysis of covariance. Results Dietitians in the practice guidelines group spent 63% more time with patients and were more likely to do an assessment and discuss results with patients than dietitians in the usual care group. Practice guidelines dietitians paid greater attention to glycemic control goals. Levels of HbA 1c improved at 3 months in 21 (88%) of practice guidelines patients compared with 16 (53%) of usual care patients. Practice guidelines patients achieved greater reductions in HbA 1c level than usual care patients (−1.00 vs −0.33). This difference was statistically significant and clinically meaningful. Conclusions/applications Dietitians responded positively to practice guidelines for type 1 diabetes. Use of guidelines resulted in changes in dietitian practices and produced greater improvements in patient blood glucose outcomes at 3 months compared with usual care. Practice guidelines did not significantly influence patient satisfaction with care or perceived quality of life. J Am Diet Assoc. 1998;98:62-70 .

129 citations

Journal ArticleDOI
TL;DR: Implementation of validated screening by using the Parents' Evaluation of Developmental Status was feasible in large, urban settings and perceived obstacles, such as the time requirement, should not prevent widespread adoption of screening.
Abstract: Objectives The purpose of this study was to examine the feasibility and effectiveness of implementation of validated developmental screening by using the Parents' Evaluation of Developmental Status in 2 urban pediatric practices. Design and methods We implemented the Parents' Evaluation of Developmental Status at Boston Children's Hospital Primary Care Center and at Joseph Smith Community Health Center as quality improvement initiatives. Each practice offered screening to all of the patients attending well-child care visits between 6 months and 8 years of age. The implementation process was investigated by using preimplementation and postimplementation surveys and a focus group of pediatric primary care providers. To assess outcomes, such as changes in identification rates and referrals for developmental and behavioral concerns, we reviewed medical charts of all of the 2- and 3-year-olds present at Children's Hospital Primary Care Center well-child care visits in the periods before and after screening implementation. Results Providers found routine screening easier than expected and feasible to conduct in a busy primary care setting. The practice change resulted in screening of 61.6% of eligible children. Compared with same-aged children before screening, after screening was implemented more behavioral concerns were detected in the 2-year-old group, and more children with developmental concerns were identified in the 3-year-old group. Referral rates for additional evaluation increased only for 3-year-olds, although the types of referrals (ie, audiology and early intervention) were consistent as those found before screening started. Conclusions Implementation of validated screening by using the Parents' Evaluation of Developmental Status was feasible in large, urban settings. Effectiveness was demonstrated via chart review documenting an increased rate of identification of developmental and behavioral concerns. Perceived obstacles, such as the time requirement, should not prevent widespread adoption of screening.

129 citations


Network Information
Related Topics (5)
Cohort study
58.9K papers, 2.8M citations
92% related
Randomized controlled trial
119.8K papers, 4.8M citations
92% related
Odds ratio
68.7K papers, 3M citations
91% related
Health care
342.1K papers, 7.2M citations
91% related
Public health
158.3K papers, 3.9M citations
90% related
Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20251
20242
20233,272
20226,893
20211,905
20201,749