Grafstein Y, Barchilon E
Dept. of Family Medicine, Romema Clinic, Kupat Holim Clalit, Jerusalem.
Harefuah. 1995 Jul;129(1-2):20-4, 79.
Communication between primary care physician and consultants is essential for continuing patient care. Several studies have noted failures of consultants to provide follow-up information to the referring physician. We studied the referral pattern in a family practice clinic, and tried to increase written communication between consultants and primary care physicians. 306 patients referred to medical consultants during a 6-month period received either a routine referral form with the patient's name, age and reason for consultation, or an experimental referral form with a special area for the consultant to fill out and return to the referring family physician via the patient. The overall referral rate was 6.4%, the most frequently consulted specialists being ophthalmologists (27%), followed by surgeons (26.4%), internists (24.7%), otolaryngologists (10%) and gynecologists (8%). Consultation reports were returned to the referring physician in 55% of the cases. The return rate was significantly higher (62.5%) for the experimental form than the standard form (48%), (p < 0.004, X2 = 15.18). This improvement in response rate was seen for all specialists and for the different types of clinics. The proposed referral form is a simple and inexpensive method of improving communication between family practitioners and specialists, thus ensuring continuity of patient care.
初级保健医生与会诊医生之间的沟通对于持续的患者护理至关重要。多项研究指出会诊医生未能向转诊医生提供后续信息。我们研究了一家家庭诊所的转诊模式,并试图增加会诊医生与初级保健医生之间的书面沟通。在6个月期间转诊给医学会诊医生的306名患者,要么收到一份包含患者姓名、年龄和会诊原因的常规转诊表格,要么收到一份实验性转诊表格,该表格有一个特殊区域供会诊医生填写并通过患者返还给转诊的家庭医生。总体转诊率为6.4%,会诊最多的专科医生是眼科医生(27%),其次是外科医生(26.4%)、内科医生(24.7%)、耳鼻喉科医生(10%)和妇科医生(8%)。55%的病例将会诊报告返还给了转诊医生。实验性表格的返还率(62.5%)显著高于标准表格(48%),(p < 0.004,X2 = 15.18)。所有专科医生以及不同类型的诊所都出现了这种回复率的提高。所提议的转诊表格是一种简单且低成本的方法,可改善家庭医生与专科医生之间的沟通,从而确保患者护理的连续性。