Document Detail

Referral of chronic hepatitis B patients from primary to specialist care: making a simple guideline work.
MedLine Citation:
PMID:  15582137     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: To evaluate a guideline selecting patients at the primary care level for referral to a specialist, to identify bottlenecks and subsequently implement and evaluate improvements. METHODS: Retrospective patient files analysis and a prospective cohort study. The study was conducted in Municipal Public Health Service (PHS), University Medical Center. Patients diagnosed with chronic hepatitis B virus (HBV) infection were referred to the PHS. Improvement of bottlenecks were identified in the referral chain, based on the guideline. Number of patients receiving correct advice, number of patients reaching the hospital for specialist care, time between notification of the PHS and final arrival in the hospital. RESULTS: The guideline for the referral of chronic HBV patients appeared to be appropriate, although one-third of the selected patients was not seen by the specialist. After the intervention more HBV patients (76 versus 61%) received correct advice from the PHS, and the number of HBV patients seen by the specialist increased by 18%. CONCLUSIONS: The referral guideline works, yet we could improve the efficiency of the guideline increasing the proportion of eligible patients reaching specialist care. In countries where mandatory reporting of HBV infections exists this guideline can be adapted to local health systems.
Maria Catharina Mostert; Jan Hendrik Richardus; Robert A de Man
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of hepatology     Volume:  41     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-07     Completed Date:  2005-05-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1026-30     Citation Subset:  IM    
Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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MeSH Terms
Cohort Studies
Guidelines as Topic* / standards
Hepatitis B, Chronic / therapy*
Patient Selection
Primary Health Care*
Prospective Studies
Public Health
Referral and Consultation*
Retrospective Studies

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