Evidence map›Paper›PMID 29376458›Full record

ArticleScandinavian journal of primary health care2018

Does an in-house internist at a GP practice result in reduced referrals to hospital-based specialist care?

Tessa C C Quanjel, Anne Winkens, Marieke D Spreeuwenberg, Jeroen N Struijs, Ron A G Winkens, Caroline A Baan, Dirk Ruwaard

Open access · goldAbstract read
In one paragraph

Article in Scandinavian journal of primary health care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Tessa C C Quanjela Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.
Anne Winkensb Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.
Marieke D Spreeuwenberga Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.
Jeroen N Struijsd Department for Quality of Care and Health Economics , Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment , Bilthoven , The Netherlands.
Ron A G Winkensf Diagnostic Centre , Maastricht University Medical Centre (Maastricht UMC+) , Maastricht , The Netherlands.
Caroline A Baand Department for Quality of Care and Health Economics , Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment , Bilthoven , The Netherlands.
Dirk Ruwaarda Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.
Maastricht University · NLNational Institute for Public Health and the Environment · NLMaastricht University Medical Centre · NLZuyd University of Applied Sciences · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveConsistent evidence on the effects of specialist services in the primary care setting is lacking. Therefore, this study evaluated the effects of an in-house internist at a GP practice on the number of referrals to specialist care in the hospital setting. Additionally, the involved GPs and internist were asked to share their experiences with the intervention.

designA retrospective interrupted times series study.

settingTwo multidisciplinary general practitioner (GP) practices.

interventionAn internist provided in-house patient consultations in two GP practices and participated in the multidisciplinary meetings. SUBJECTS: The referral data extracted from the electronic medical record system of the GP practices, including all referral letters from the GPs to specialist care in the hospital setting.

main outcome measuresThe number of referrals to internal medicine in the hospital setting. This study used an autoregressive integrated moving average model to estimate the effect of the intervention taking account of a time trend and autocorrelation among the observations, comparing the pre-intervention period with the intervention period.

resultsIt was found that the referrals to internal medicine did not statistically significant decrease during the intervention period.

conclusionsThis small explorative study did not find any clues to support that an in-house internist at a primary care setting results in a decrease of referrals to internal medicine in the hospital setting. Key Points An in-house internist at a primary care setting did not result in a significant decrease of referrals to specialist care in the hospital setting. The GPs and internist experience a learning-effect, i.e. an increase of knowledge about internal medicine issues.

Indexed as

General PracticeHospitalsInternal MedicinePractice Patterns, Physicians'Primary Health CareReferral and ConsultationSpecializationFemaleHealth ServicesHumansMalePhysiciansRetrospective Studiesgeneral practiceprimary careprimary care plusreferralSubstitution

Identifiers

PMID29376458
PMCPMC5901446
OpenAlexW2790697252

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.