Clinical trial NCT01976221: Priority Setting and Waiting Time Decision in the Referral Process, How and by Whom?
Official title: Priority Setting and Waiting Time Decision in the Referral Process, How and by Whom? A Prospective Cluster Randomized Controlled Trial on the Effects of an Education Program in Priority Setting and Waiting Time Decision in Referrals
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Communication
Keywords: Comprehensive referrals
Appropriate referring
Priority setting
Waiting time in hospital
Lead sponsor: University of Bergen
Sponsor class: OTHER
First posted: 2013-11-05
Enrollment: 0
Sex: ALL
Minimum age (years): 25
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: ECOLOGIC_OR_COMMUNITY
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: General practitioners referring to Stavanger University Hospital

Brief summary: The referral letter is used for different purposes: a request for a special diagnostic assessment or medical treatment that the GP cannot perform for the patient, an invitation to have a second opinion about a clinical problem or a wish for mutual responsibility for the medical handling. The individual referral rate between GPs varies greatly, and is an important determinant of secondary care utilization. We wanted to study the various elements and factors having an impact on the referral process, from the moment the GP decides to refer the patient until the hospital consultant assess the referral and prioritise the patient for further investigation or treatment. How and why are we, the GPs who refer, so different? We wanted to

1. identify and describe general practitioners' reflections on and attitudes to the referral process and cooperation with hospital specialists
2. identify and describe hospital consultants' reflections on and attitudes to the referral process and cooperation with general practitioners
3. identify typologies characterising GPs in the referral practice

Detailed description: Design and Methods:

We did two qualitative and one quantitative study. The first was a focus group study with GPs in CPD groups, the second an individual study with hospital consultants, both analyses by using systematic text condensation. The third was a quantitative registration of impressions, facts and feelings in the referral process using a principal component analysis to find typologies for GPs who refer to hospital.

Participants:

GPs referring to Stavanger University Hospital. Hospital consultants at Stavanger University Hospital.

Intervention: No intervention was performed.

Time schedule:

Data Collection finished May 2014.

Eligibility criteria: Inclusion Criteria:

All the 300 GPs referring to Stavanger University Hospital who participate in one of the 58 CPD groups in South Rogaland County and who agree to participate in the study are included.

Exclusion Criteria:

GPs not willing to participate

Primary outcomes:
measure: Use of priority setting and waiting time indication in referrals
timeFrame: 1 year
Secondary outcomes:
measure: Referral rates
timeFrame: One year
Other outcomes:
measure: Inter-rater agreement between GPs and hospital consultants on priority setting and waiting time for patients
timeFrame: One year
Locations:
city: Stavanger
country: Norway
facility: Stavanger University Hospital
Study officials:
affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway
name: Anders Baerheim, Professor
role: STUDY_CHAIR
References:
citation: Thorsen O, Hartveit M, Baerheim A. General practitioners' reflections on referring: an asymmetric or non-dialogical process? Scand J Prim Health Care. 2012 Dec;30(4):241-6. doi: 10.3109/02813432.2012.711190. Epub 2012 Oct 10.