Center to Bridge Research, Practice, & Policy, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
BMC Health Serv Res. 2011 Jul 13;11:168. doi: 10.1186/1472-6963-11-168.
Performance of specialty referrals is coming under scrutiny, but a lack of identifiable measures impedes measurement efforts. The objective of this study was to systematically review the literature to identify published measures that assess specialty referrals.
We performed a systematic review of the literature for measures of specialty referral. Searches were made of MEDLINE and HealthSTAR databases, references of eligible papers, and citations provided by content experts. Measures were eligible if they were published from January 1973 to June 2009, reported on validity and/or reliability of the measure, and were applicable to Organization for Economic Cooperation and Development healthcare systems. We classified measures according to a conceptual framework, which underwent content validation with an expert panel.
We identified 2,964 potentially eligible papers. After abstract and full-text review, we selected 214 papers containing 244 measures. Most measures were applied in adults (57%), assessed structural elements of the referral process (60%), and collected data via survey (62%). Measures were classified into non-mutually exclusive domains: need for specialty care (N = 14), referral initiation (N = 73), entry into specialty care (N = 53), coordination (N = 60), referral type (N = 3), clinical tasks (N = 19), resource use (N = 13), quality (N = 57), and outcomes (N = 9).
Published measures are available to assess the specialty referral process, although some domains are limited. Because many of these measures have been not been extensively validated in general populations, assess limited aspects of the referral process, and require new data collection, their applicability and preference in assessment of the specialty referral process is needed.
专业转诊的表现正受到审查，但缺乏可识别的衡量标准阻碍了衡量工作。本研究的目的是系统地审查文献，以确定评估专业转诊的已发表衡量标准。
我们对专业转诊的衡量标准进行了系统的文献回顾。搜索了 MEDLINE 和 HealthSTAR 数据库、合格论文的参考文献以及内容专家提供的引文。如果衡量标准是在 1973 年 1 月至 2009 年 6 月期间发表的，报告了衡量标准的有效性和/或可靠性，并且适用于经济合作与发展组织的医疗保健系统，则该衡量标准符合条件。我们根据一个概念框架对衡量标准进行分类，该框架通过专家小组进行了内容验证。
我们确定了 2964 篇潜在的合格论文。经过摘要和全文审查，我们选择了 214 篇包含 244 项衡量标准的论文。大多数衡量标准适用于成年人（57%），评估转诊过程的结构要素（60%），并通过调查收集数据（62%）。衡量标准分为非互斥的领域：专业护理的需求（N=14）、转诊启动（N=73）、进入专业护理（N=53）、协调（N=60）、转诊类型（N=3）、临床任务（N=19）、资源使用（N=13）、质量（N=57）和结果（N=9）。
虽然有些领域有限，但已有可用的衡量标准来评估专业转诊过程。由于这些衡量标准中的许多在一般人群中尚未得到广泛验证，仅评估转诊过程的有限方面，并且需要新的数据收集，因此需要评估专业转诊过程的适用性和偏好。
