Referral from primary to secondary care in Germany: Developing a taxonomy based on cluster analysis

Scandinavian Journal of Public Health

Volumn 40, Issue 6, 2012, Pages 571-578

  Hirsch, Oliver ^a   Träger, Susanne ^a   Bösner, Stefan ^a   Ilhan, Muazzez ^a   Becker, Annette ^a   Baum, Erika ^a   Donner Banzhoff, Norbert ^a  

^a PHILIPPS UNIVERSITY MARBURG   (Germany)

Author keywords

Cluster analysis; primary care physicians; referral and consultation

Indexed keywords

ADULT; ARTICLE; CLASSIFICATION; CLINICAL PRACTICE; CLUSTER ANALYSIS; FEMALE; GENERAL PRACTICE; GENERAL PRACTITIONER; GERMANY; HUMAN; MALE; METHODOLOGY; MIDDLE AGED; ORGANIZATION AND MANAGEMENT; PATIENT REFERRAL; PRIMARY HEALTH CARE; STATISTICS;

ADULT; CLASSIFICATION; CLUSTER ANALYSIS; FAMILY PRACTICE; FEMALE; GENERAL PRACTITIONERS; GERMANY; HUMANS; MALE; MIDDLE AGED; PHYSICIAN'S PRACTICE PATTERNS; PRIMARY HEALTH CARE; REFERRAL AND CONSULTATION;

EID: 84866262310     PISSN: 14034948     EISSN: 16511905     Source Type: Journal    
DOI: 10.1177/1403494812455113     Document Type: Article

References (30)

1. Loudon I. The principle of referral: the gatekeeping role of the GP. Br J Gen Pract 2008;58:128–30; discussion 30.
2. Bodenheimer T. Lo B. Casalino L. Primary care physicians should be coordinators, not gatekeepers. JAMA 1999;281:2045–9.
3. Grobe T.G.D. Schwartz F.W. Institut für Sozialmedizin, Epidemiologie Gesundheitssystemforschung. GEK-Report ambulant-ärztliche Versorgung 2008. Auswertung der GEK-Gesundheitsberichtserstattung, Schwerpunkt: Erkrankung und zukünftige Ausgaben [Institute for social medicine, epidemiology, health system research. GEK report on ambulatory medical provision 2008. Analysis of the GEK health report, main focus: disease and future costs.] St. Augustin: Asgard-Verlag; 2008. p.1–252.
4. Busse R. Reisberg A. Health care systems in transition: Germany. Copenhagen: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies; 2004.
5. Forrest C.B. Nutting P.A. Starfield B. von Schrader S. Family physicians’ referral decisions: results from the ASPN referral study. J Fam Pract. 2002;51:215–22.
6. Thies-Zajonc S. Köhle M. Szecsenyi J. Überweisungsverhalten von Hausärzten, Gebietsärzten und Klinikern [Referral behaviour of primary care physicians, district physicians, and clinicians]. Der Allgemeinarzt 1990;12: 568–80.
7. Rosemann T. Wensing M. Rueter G. Szecsenyi J. Referrals from general practice to consultants in Germany: if the GP is the initiator, patients’ experiences are more positive. BMC Health Serv Res 2006;6:5.
8. Donohoe M.T. Kravitz R.L. Wheeler D.B. Chandra R. Chen A. Humphries N. Reasons for outpatient referrals from generalists to specialists. J Gen Intern Med 1999;14:281–6.
9. Fylkesnes K. Determinants of health care utilization – visits and referrals. Scand J Soc Med 1993;21:40–50.
10. Miller M.D. Ferris D.G. Measurement of subjective phenomena in primary care research: the Visual Analogue Scale. Fam Pract Res J 1993;13:15–24.
11. Bacher J. Pöge A. Wenzig K. Clusteranalyse. Anwendungsorientierte Einführung in Klassifikationsverfahren [Cluster analysis. Practical introduction in classification measures]. Munich: Oldenbourg; 2010.
12. Schendera C.F.G. Clusteranalyse mit SPSS: Mit Faktorenanalyse. [Cluster analysis with SPSS: including factor analysis]. Munich: Oldenbourg; 2009.
13. Janssen J. Laatz W. Statistische Datenanalyse mit SPSS für Windows [Statistical data analysis with SPSS for Windows.]. Berlin: Springer; 2005.
14. Romesburg C. Cluster analysis for researchers. Morrisville: Lulu; 2004.
15. Jaccard J. Becker M.A. Statistics for the behavioral sciences. Belmont: Wadsworth; 2009.
16. Kaufman L. Rousseeuw P.J. Finding groups in data. An introduction to cluster analysis. Hoboken: Wiley; 2005.
17. Yang K. Making sense of statistical methods in social research. London: Sage; 2010.
18. Bundesärztekammer. Tätigkeitsbericht 2010 der Bundesärztekammer [2010 Proceedings of the German Medical Association]. Berlin: Bundesärztekammer; 2011.
19. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988.
20. Piterman L. Koritsas S. Part II. General practitioner-specialist referral process. Intern Med J 2005;35:491–6.
21. Chenot J.F. Pieper A. Kochen M.M. Himmel W. [Communication and exchange of clinical findings for low back pain between general practitioners and orthopaedic surgeons: a retrospective observational study]. Schmerz. 2009;23:173–9.
22. O'Donnell C.A. Variation in GP referral rates: what can we learn from the literature? Fam Pract 2000;17:462–71.
23. Delnoij D. Spreeuwenberg P. Variation in GP's referral rates to specialists in internal medicine. Eur J Public Health 1997;7:427–35.
24. Sullivan C.O. Omar R.Z. Ambler G. Majeed A. Case-mix and variation in specialist referrals in general practice. Br J Gen Pract 2005;55:529–33.
25. Fertig A. Roland M. King H. Moore T. Understanding variation in rates of referral among general practitioners: are inappropriate referrals important and would guidelines help to reduce rates? BMJ 1993;307:1467–70.
26. Cummins R.O. Jarman B. White P.M. Do general practitioners have different “referral thresholds”? Br Med J (Clin Res Ed). 1981;282:1037–9.
27. Wilkin D. Smith A. Explaining variation in general practitioner referrals to hospital. Fam Pract 1987;4: 160–9.
28. Knottnerus J.A. Between iatrotropic stimulus and interiatric referral: the domain of primary care research. J Clin Epidemiol 2002;55:1201–6.
29. Valderas J.M. Starfield B. Forrest C.B. Sibbald B. Roland M. Ambulatory care provided by office-based specialists in the United States. Ann Fam Med 2009;7:104–11.
30. Donohoe M.T. Comparing generalist and specialty care: discrepancies, deficiencies, and excesses. Arch Intern Med 1998;158:1596–608.