Referral

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

Promotional Tactics for Online Viral Marketing Campaigns: How Scarcity and Personalization Affect Seed Stage Referrals

Abstract: Against the backdrop of consumers being deluged with traditional online advertising, which is increasingly manifesting in inefficient conversion outcomes, viral marketing has become a pivotal component of marketing strategy. However, despite a robust understanding about the impact of viral marketing as well as of factors that drive consumer referral engagement, we know very little about the effect of traditional promotional tactics on consumer referral decisions. Drawing on a randomized field experiment in the context of an online fashion service named StyleCrowd, we investigate the effects of scarcity and personalization, two classical promotional cues that have become ubiquitous on the web and have received only minimal attention hitherto, on actual referral behavior. Our analysis reveals that using these cues in promotional campaigns is a balancing act: While scarcity cues affect referral propensity regardless of whether a campaign is personalized or not, personalization cues are particularly effective when scarcity is absent, yet are cancelled out when scarcity is prevalent. We demonstrate that consumers' perceptions of offer value drive the impact of scarcity on referral likelihood, while consumer gratitude vis-a-vis the marketer is the underlying mechanism for personalization's influence on referral decisions.

Pathways to care in children at risk of attention-deficit hyperactivity disorder

Abstract: Background There is underdiagnosis of and low use of specialist services for attention-deficit hyperactivity disorder (ADHD). Aims To quantify the filters in the help-seeking pathway through primary care and to investigate factors influencing progress for children at risk of ADHD. Method A total of 127 children (5-11 years old) with pervasive hyperactivity who passed each filter (primary care attendance and general practitioner (GP) recognition of disorder) were compared with those who had not. Results Primary care attendance was only associated with parental perception of the behaviour as problematic (OR 2.11; 95% CI 1.11-4.03). However, GP recognition was related to both parent and child factors — parental request for referral (OR 20.83; 95% CI 3.05-142.08) and conduct problems (OR 1.48; 95% CI 1.04-2.12). GP non-recognition was the main barrier in the pathway to care; following recognition, most children were referred. Conclusions Parents can be regarded as the main gatekeepers for access to specialist services.

Primary care clinicians evaluate integrated and referral models of behavioral health care for older adults: results from a multisite effectiveness trial (PRISM-e).

Abstract: BACKGROUND Recent studies have shown that integrated behavioral health services for older adults in primary care improves health outcomes. No study, however, has asked the opinions of clinicians whose patients actually experienced integrated rather than enhanced referral care for depression and other conditions. METHOD The Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E) study was a randomized trial comparing integrated behavioral health care with enhanced referral care in primary care settings across the United States. Primary care clinicians at each participating site were asked whether integrated or enhanced referral care was preferred across a variety of components of care. Managers also completed questionnaires related to the process of care at each site. RESULTS Almost all primary care clinicians (n = 127) stated that integrated care led to better communication between primary care clinicians and mental health specialists (93%), less stigma for patients (93%), and better coordination of mental and physical care (92%). Fewer thought that integrated care led to better management of depression (64%), anxiety (76%), or alcohol problems (66%). At sites in which the clinicians were rated as participating in mental health care, integrated care was highly rated as improving communication between specialists in mental health and primary care. CONCLUSIONS Among primary care clinicians who cared for patients that received integrated care or enhanced referral care, integrated care was preferred for many aspects of mental health care.

Understanding variation in rates of referral among general practitioners: are inappropriate referrals important and would guidelines help to reduce rates?

Abstract: OBJECTIVES--To determine the extent to which variation in rates of referral among general practitioners may be explained by inappropriate referrals and to estimate the effect of implementing referral guidelines SETTING--Practices within Cambridge Health Authority and Addenbrooke's Hospital, Cambridge MAIN OUTCOME MEASURES--Data on practice referral rates from hospital computers, inappropriate referrals as judged by hospital consultants, and inappropriate referrals as judged against referral guidelines which had been developed locally between general practitioners and specialists Effect of referral guidelines on referral patterns as judged by general practitioners using the guidelines in clinical practice RESULTS--There was 25-fold variation in referral rates among general practices According to the specialists, 96% (95% confidence interval 64% to 129%) of referrals by general practitioners and 89% (26% to 152%) of referrals from other specialists were judged possibly or definitely inappropriate Against locally determined referral guidelines 159% of referrals by general practitioners were judged possibly inappropriate (118% to 200%) Elimination of all possibly inappropriate referrals could reduce variation in practice referral rates only from 25-fold to 21-fold An estimate of the effect of using referral guidelines for 60 common conditions in routine general practice suggested that application of guidelines would have been unlikely to reduce rates of referral in hospital (95% confidence interval -45% to 86% of consultations resulting in referral) CONCLUSION--The variation in referral rates among general practitioners in Cambridge could not be explained by inappropriate referrals Application of referral guidelines would be unlikely to reduce the number of patients referred to hospital

Randomised controlled trials in primary care: case study.

Abstract: Editorial by Thomas Although over 90% of patient contacts within the NHS occur in primary care, many of the interventions used in this setting remain unproved.1 The relevance of research undertaken in secondary or tertiary care to general practice is questionable, and more research based in primary care is needed.2 Increasing research in primary care will inevitably increase demand for randomised controlled trials in this setting. Some of the trials will be of health service interventions (pragmatic trials),3 where the focus lies in assessing the cost effectiveness of an intervention rather than efficacy or safety. The difficulties experienced in doing randomised controlled trials in primary care have been reported4–6 and are not restricted to this setting. 7 8 We discuss some of the issues that must be considered when conducting and interpreting the results of trials in primary care using examples generated during a trial of the management of dyspepsia (box). #### Birmingham open access endoscopy study The study aimed to evaluate the effectiveness of two management strategies for patients presenting in primary care with symptoms of dyspepsia. Two randomised controlled trials were conducted concurrently, with eligibility being determined by the patient's age at presentation. Randomisation was done at the individual patient level by using sealed opaque, sequentially numbered envelopes during a primary care consultation for dyspepsia. ##### Initial endoscopy trial Eligible patients— 50 years of age or older. Intervention— Referred for open access endoscopy. ##### Test and endoscopy trial Eligible patients— Under 50 years. Intervention —Tested for Helicobacter pylori antibodies with Helisal near patient test. Patients with positive results referred for open access endoscopy; those with negative results received symptomatic treatment only. Control arms (both trials)— Managed according to “usual practice” excluding open access endoscopy. This included antacids, H2 receptor antagonists, proton pump inhibitors, outpatient gastroenterology referral, facilitated or direct access endoscopy (for example, vetted by consultant), …