Observational studyBMC family practice2016
Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study.
Observational study in BMC family practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed.
- Disparities in rate, triggers, and management in pediatric and adult cases of suspected drug-induced anaphylaxis in Canada.Immunity, inflammation and disease · 2018Trial
- Integrated Implementation Strategies to Promote the Use of AI-Assisted Diagnostic Software for Lung Nodule Screening in China: Process Evaluation Based on the RE-AIM Framework.JMIR formative research · 2026Article
- Utility of optometrist referrals for glaucoma evaluation in a young adult population.Clinical & experimental optometry · 2026Article
- Referral compliance and subsequent hospital admissions for COPD and cardiovascular disease in the Netherlands: a data linkage study.BMC health services research · 2025Article
- Observational
- Availability of anti-rabies vaccine and rabies immunoglobulin in Indian health facilities: a nationwide cross-sectional health facility survey.The Lancet regional health. Southeast Asia · 2025Article
- Article
- Epidemiological trends and economic burden of genital warts in Dutch primary care.BMJ public health · 2025Article
- Socioeconomic and behavioral determinants of non-compliance with physician referrals following community screening for diabetes, hypertension and hyperlipidemia: a mixed-methods study.Scientific reports · 2023Article
- Community engagement to inform development of strategies to improve referral for hypertension: perspectives of patients, providers and local community members in western Kenya.BMC health services research · 2023Article
- Compliance with Specialist Referral for Increased Cancer Risk in Low-Resource Settings: In-Person vs. Telehealth Options.Cancers · 2023Article
- Implementation of a Post-Encounter Telephone Call at a Student-Run Free Clinic to Promote Preventive Medicine and Early Clinical Education.Journal of community health · 2023Article
- 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.BMC health services research · 2022Observational
- Differences in Hospitalization Outcomes of Kidney Disease between Patients Who Received Care by Nephrologists and Non-Nephrologist Physicians: A Propensity-Score-Matched Study.Journal of clinical medicine · 2021Article
- Article
- The Use of Ancillary Services Under a Bundled Care Versus a Fee-For-Service Payment Model.Female pelvic medicine & reconstructive surgery · 2021Article
- Socioeconomic status is not associated with the delivery of care in people with diabetes but does modify HbA1c levels: An observational cohort study (Elzha-cohort 1).International journal of clinical practice · 2021Observational
- Referral of sick children and levels of adherence by carers: implications on quality health care in the middle belt of Ghana.Ghana medical journal · 2021Article
- Referral practices of medical practitioners in central South Africa to physiotherapy services for patients living with musculoskeletal conditions.The South African journal of physiotherapy · 2021Article
- Once is rarely enough: can social prescribing facilitate adherence to non-clinical community and voluntary sector health services? Empirical evidence from Germany.BMC public health · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn a gatekeeper system, primary care physicians and patients jointly decide whether or not medical specialist care is needed. However, it is the patient who decides to actually use the referral. Referral non-compliance could delay diagnosis and treatment. The objective of this study was to assess patient compliance with a referral to medical specialist care and identify patient and practice characteristics that are associated with it.
methodsObservational study using data on 48,784 referrals to medical specialist care derived from electronic medical records of 58 general practices for the period 2008-2010. Referral compliance was based on claims data of medical specialist care. Logistic multilevel regression analyses were conducted to determine associations between patient and general practice characteristics and referral compliance.
resultsIn 86.6% of the referrals, patients complied. Patient and not practice characteristics were significantly associated with compliance. Patients from deprived urban areas and patients aged 18-44 years were less likely to comply, whereas patients aged 65 years and older were more likely to comply.
conclusionAbout 1 in 8 patients do not use their referral. These patients may not receive adequate care. Demographic and socio-economic factors appear to affect compliance. The results of this study may be used to make general practitioners more aware that some patients are more likely to be noncompliant with referrals.
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