Eaglstein W H, Laszlo K S
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Florida, USA.
Arch Dermatol. 1996 Mar;132(3):292-4.
As changes in the health care system aim to reduce the cost of medical care, physicians need to understand and be able to justify their reasons for referring patients. To learn the basis for making referrals, we asked 116 referring physicians why they made referrals to one university-based physician. We also assessed the referring physicians' satisfaction.
A total of 112 of the 116 physicians responded in reference to 114 patients. The responses fit into five categories. Fifty of 114 patient were referred for therapy; 16 patients, for a diagnosis; and 16, for a combination of diagnosis and therapy. Other reasons in descending order of frequency were (1) a nondermatologist referring the patient to a dermatologist, (2) self-referral, ie, the patient was not referred by the physician, and (3) the patient's personality was difficult. The referring physicians were satisfied in 94 instances.
The most frequent reason for referral was for therapy. This observation may be generally true for many physicians, since it is consistent with results of two other studies, in different fields, that we were able to find. Eighty-two percent of referrals were satisfactory to the referring physicians. Most of the physicians who were unsatisfied with the referral process stated they had not received a follow-up letter from the consulted physician.
由于医疗保健系统的变革旨在降低医疗成本，医生需要理解并能够说明转诊患者的理由。为了解转诊的依据，我们询问了116位转诊医生他们将患者转诊给一位大学附属医院医生的原因。我们还评估了转诊医生的满意度。
116位医生中有112位针对114名患者做出了回应。这些回应可分为五类。114名患者中有50名被转诊接受治疗；16名患者被转诊进行诊断；16名患者被转诊同时进行诊断和治疗。按频率从高到低排列的其他原因依次为：（1）非皮肤科医生将患者转诊给皮肤科医生；（2）自我转诊，即患者不是由医生转诊的；（3）患者性格难相处。转诊医生对94例情况表示满意。
转诊最常见的原因是治疗。这一观察结果对许多医生来说可能普遍适用，因为它与我们能找到的另外两项不同领域的研究结果一致。82%的转诊情况让转诊医生满意。大多数对转诊过程不满意的医生表示，他们没有收到会诊医生的随访信。
