Trial reportBMC health services research2017
The effect of referral templates on out-patient quality of care in a hospital setting: a cluster randomized controlled trial.
Trial report in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01470963 (Practical Health Co-operation - a Randomised Controlled Intervention Study. The Impact of a Referral Template on Quality of Care and Health Care Co-operation Between Primary and Secondary Care), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Practical Health Co-operation - a Randomised Controlled Intervention Study. The Impact of a Referral Template on Quality of Care and Health Care Co-operation Between Primary and Secondary Care
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Electronic checklists improve referral letters in gastroenterology: a randomized vignette survey.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2018Trial
- Article
- Evaluating referrals between rural district hospitals and a regional hospital in South Africa.African journal of primary health care & family medicine · 2025Article
- Essential information for transition of care for frail elderly patients in Japan: A qualitative study.Journal of general and family medicine · 2022Article
- Community healthcare workers' experiences with the care of clients on antiretroviral therapy in the community.The Pan African medical journal · 2022Article
- A Qualitative Study to Explore the Barriers for Nonadherence to Referral to Hospital Births by Women with High-Risk Pregnancies in Nepal.International journal of environmental research and public health · 2021Article
- Examining the Association Between Referral Quality, Wait Time and Patient Outcomes for Patients Referred to an IBD Specialty Program.Journal of the Canadian Association of Gastroenterology · 2020Article
- Improving quality of referral letters from primary to secondary care: a literature review and discussion paper.Primary health care research & development · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe assessment of quality of care is an integral part of modern medicine. The referral represents the handing over of care from the general practitioner to the specialist. This study aimed to assess whether an improved referral could lead to improved quality of care.
methodsA cluster randomized trial with the general practitioner surgery as the clustering unit was performed. Fourteen surgeries in the area surrounding the University Hospital of North Norway Harstad were randomized stratified by town versus countryside location. The intervention consisted of implementing referral templates for new referrals in four clinical areas: dyspepsia; suspected colorectal cancer; chest pain; and confirmed or suspected chronic obstructive pulmonary disease. The control group followed standard referral practice. Quality of treatment pathway as assessed by newly developed quality indicators was used as main outcome. Secondary outcomes included subjective quality assessment, positive predictive value of referral and adequacy of prioritization. Assessment of outcomes was done at the individual level. The patients, hospital doctors and outcome assessors were blinded to the intervention status.
resultsA total of 500 patients were included, with 281 in the intervention and 219 in the control arm. From the multilevel regression model the effect of the intervention on the quality indicator score was insignificant at 1.80% (95% CI, -1.46 to 5.06, p = 0.280). No significant differences between the intervention and the control groups were seen in the secondary outcomes. Active use of the referral intervention was low, estimated at approximately 50%. There was also wide variation in outcome scoring between the different assessors.
conclusionsIn this study no measurable effect on quality of care or prioritization was revealed after implementation of referral templates at the general practitioner/hospital interface. The results were hindered by a limited uptake of the intervention at GP surgeries and inconsistencies in outcome assessment.
trial registrationThe study was registered under registration number NCT01470963 on September 5th, 2011.
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