Dowell D A, Jones T
J Community Psychol. 1980 Jan;8(1):61-9. doi: 10.1002/1520-6629(198001)8:1<61::aid-jcop2290080111>3.0.co;2-1.
This article reports a study of referrals among social service and mental health agencies. Staff from human service agencies were interviewed about the process of referring and asked to make simulated referrals using mock clients constructed for this study. Interview data show lack of communication and inappropriate referrals as the biggest problems with the referral system. Interjudge agreement about the simulated referral choices was found to be not significantly different from chance. The data also suggest that agency staff refer on the basis of "habits" as much or more than on the basis of client problems. The frequency of inappropriate simulated referrals was relatively high (15%) considering that agencies included in the sample are large public agencies with broad definitions of what clients are appropriate for their services. Implications of these findings are discussed in terms of existing incentives for agencies to cooperate or compete and need for methodology to evaluate service delivery systems or networks.
本文报告了一项关于社会服务机构和心理健康机构之间转诊情况的研究。对来自公共服务机构的工作人员就转诊流程进行了访谈，并要求他们使用为本研究构建的虚拟客户进行模拟转诊。访谈数据显示，沟通不畅和不恰当的转诊是转诊系统存在的最大问题。研究发现，对于模拟转诊选择的评判者间一致性与随机情况没有显著差异。数据还表明，机构工作人员进行转诊更多是基于“习惯”，而非客户问题。考虑到样本中的机构是大型公共机构，对适合其服务的客户有宽泛定义，不恰当模拟转诊的频率相对较高（15%）。本文从机构合作或竞争的现有激励因素以及评估服务提供系统或网络的方法需求等方面讨论了这些发现的意义。
