Incomplete specialty referral among children in community health centers

Katharine Zuckerman, Xin Cai, James M. Perrin, Karen Donelan

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To assess rates of incomplete specialty referral (referral not resulting in a specialist visit) and risk factors for incomplete referral in pediatric community health care centers. Study design: In this cross-sectional study, we used referral records and electronic health records to calculate rate of incomplete referral in 577 children referred from two health care centers in underserved communities to any of 19 pediatric specialties at an affiliated tertiary care center, over 7 months in 2008-2009. We used logistic regression to test the association of incomplete referral with child/family sociodemographic and health care system factors. Results: Of the children, 30.2% had an incomplete referral. Incomplete referral rates were similar at the two health care centers, but varied from 10% to 73% according to specialty clinic type. In multivariate analysis, sociodemographic factors of older child age, public insurance status, and no chronic health conditions correlated with incomplete referral, as did health care system factors of surgical specialty clinic type, low patient volume, longer wait for visit, and appointment rescheduling. Conclusion: Almost one-third of children referred to specialists were unable to complete the referral in a timely manner. To improve specialty access, health care organizations and policymakers should target support to families with high-risk children and remediate problematic health care system features.

Original languageEnglish (US)
Pages (from-to)142-148
Number of pages7
JournalJournal of Pediatrics
Volume158
Issue number1
DOIs
StatePublished - Jan 2011

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Community Health Centers
Referral and Consultation
Delivery of Health Care
Surgical Specialties
Pediatrics
Community Health Services
Insurance Coverage
Family Health
Electronic Health Records
Tertiary Care Centers
Appointments and Schedules
Multivariate Analysis
Cross-Sectional Studies
Logistic Models
Organizations

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Incomplete specialty referral among children in community health centers. / Zuckerman, Katharine; Cai, Xin; Perrin, James M.; Donelan, Karen.

In: Journal of Pediatrics, Vol. 158, No. 1, 01.2011, p. 142-148.

Research output: Contribution to journalArticle

Zuckerman, Katharine ; Cai, Xin ; Perrin, James M. ; Donelan, Karen. / Incomplete specialty referral among children in community health centers. In: Journal of Pediatrics. 2011 ; Vol. 158, No. 1. pp. 142-148.
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