Wilkin D, Smith A
Department of General Practice, University of Manchester, Rusholme Health Centre, England.
Fam Pract. 1987 Sep;4(3):160-9. doi: 10.1093/fampra/4.3.160.
Reported rates of referral by individual general practitioners to hospitals range from less than 1% of all consultations to more than 20%. Research on variations in rates of referral by general practitioners in the UK is reviewed here. Studies have largely failed to account for variation either in terms of differences in the characteristics of patients or differences in the doctors and their practices. It is argued that this failure arises because most studies do not distinguish between different types of referral or reasons for making a referral. In order to begin to explain variations it is necessary to identify the stages in the complex process of decision making. A theoretical model of the referral decision is advanced, which is intended to provide a framework for further research on the referral process.
个体全科医生将患者转诊至医院的报告比例从占所有会诊的不到1%到超过20%不等。本文回顾了英国全科医生转诊率差异的相关研究。这些研究在很大程度上未能从患者特征差异或医生及其诊疗行为差异的角度解释这种差异。有人认为，这种失败的原因在于大多数研究没有区分不同类型的转诊或转诊原因。为了开始解释差异，有必要识别复杂决策过程中的各个阶段。本文提出了一个转诊决策的理论模型，旨在为进一步研究转诊过程提供一个框架。
