TY - JOUR
T1 - Dutch general practitioners' referral of children to specialists
T2 - a comparison between 1987 and 2001
AU - Otters, Hanneke
AU - van der Wouden, Johannes C
AU - Schellevis, François G
AU - van Suijlekom-Smit, Lisette W A
AU - Koes, Bart W
PY - 2004/11
Y1 - 2004/11
N2 - BACKGROUND: Although children are frequently referred to specialists, detailed information on referral patterns of them is scarce. Even less information is available on how referral patterns evolve over time.AIMS: To examine current referral patterns for children aged 0-17 years and compare these with referral patterns reported for 1987.DESIGN OF STUDY: Data were analysed from two national cross-sectional surveys, performed in 2001 (91 general practices) and in 1987 (103 general practices).SETTING: Dutch general practice.METHOD: All new referrals to specialists were assessed by age, sex, International Classification of Primary Care (ICPC) category, specialty referred to, and specific episodes of disease. Referral measures were quantified as new referrals per 1000 person-years and per 100 new episodes, a measure of likelihood of a young person with a specific diagnosis to be referred. Rates in 2001 were compared with those from 1987.RESULTS: Referral rates decreased from 138 per 1000 person-years in 1987, to 84 per 1000 person-years in 2001. Age differences in referral rates were similar in both surveys. Compared with 1987, more boys than girls were referred to specialists. The overall likelihood of a condition being referred decreased from 8.0 per 100 episodes in 1987 to 6.5 per 100 episodes in 2001. Reasons for referral had also changed by 2001, particularly for the ear, nose, and throat (ENT) specialist and ophthalmologist. Moreover, referral rates for acute otitis media, refractive disorders, and vision problems decreased two- to fourfold in 2001.CONCLUSION: Presently, Dutch general practitioners tend to manage more health problems themselves and refer less young people to specialists.
AB - BACKGROUND: Although children are frequently referred to specialists, detailed information on referral patterns of them is scarce. Even less information is available on how referral patterns evolve over time.AIMS: To examine current referral patterns for children aged 0-17 years and compare these with referral patterns reported for 1987.DESIGN OF STUDY: Data were analysed from two national cross-sectional surveys, performed in 2001 (91 general practices) and in 1987 (103 general practices).SETTING: Dutch general practice.METHOD: All new referrals to specialists were assessed by age, sex, International Classification of Primary Care (ICPC) category, specialty referred to, and specific episodes of disease. Referral measures were quantified as new referrals per 1000 person-years and per 100 new episodes, a measure of likelihood of a young person with a specific diagnosis to be referred. Rates in 2001 were compared with those from 1987.RESULTS: Referral rates decreased from 138 per 1000 person-years in 1987, to 84 per 1000 person-years in 2001. Age differences in referral rates were similar in both surveys. Compared with 1987, more boys than girls were referred to specialists. The overall likelihood of a condition being referred decreased from 8.0 per 100 episodes in 1987 to 6.5 per 100 episodes in 2001. Reasons for referral had also changed by 2001, particularly for the ear, nose, and throat (ENT) specialist and ophthalmologist. Moreover, referral rates for acute otitis media, refractive disorders, and vision problems decreased two- to fourfold in 2001.CONCLUSION: Presently, Dutch general practitioners tend to manage more health problems themselves and refer less young people to specialists.
KW - Adolescent
KW - Age Factors
KW - Child
KW - Child, Preschool
KW - Cross-Sectional Studies
KW - Decision Making
KW - Family Practice/statistics & numerical data
KW - Female
KW - Health Services Accessibility
KW - Health Surveys
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Netherlands
KW - Practice Patterns, Physicians'/trends
KW - Referral and Consultation/trends
M3 - Article
C2 - 15527611
VL - 54
SP - 848
EP - 852
JO - British Journal of General Practice
JF - British Journal of General Practice
SN - 0960-1643
IS - 508
ER -