Morgan D
Health Services Research Unit, University of Kent, Canterbury.
Psychol Med. 1989 Aug;19(3):743-53. doi: 10.1017/s003329170002434x.
Investigation into the referral histories of a consecutive series of new patients attending two psychiatric out-patient clinics questioned the assumption that only the more severe and problematic cases are selected by general practitioners for specialist referral. In 40% of cases, clinical indications only became decisive in relation to emergent difficulties in managing the case, while 38% of patients or their relatives requested referral. The implications of these observations are considered in relation to alternative models of psychiatric intervention in the management of psychosocial disorders in primary care.
对连续就诊于两家精神科门诊的一系列新患者转诊病史的调查，对“只有病情更严重、问题更多的病例才会被全科医生选出来转诊至专科医生处”这一假设提出了质疑。在40%的病例中，临床指征仅在处理病例出现困难时才起决定性作用，而38%的患者或其亲属要求转诊。结合初级保健中精神社会障碍管理的替代精神科干预模式，对这些观察结果的意义进行了探讨。
