| Referral of chronic hepatitis B patients from primary to specialist care: making a simple guideline work. | |
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MedLine Citation:
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PMID: 15582137 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Maria Catharina Mostert; Jan Hendrik Richardus; Robert A de Man |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Journal of hepatology Volume: 41 ISSN: 0168-8278 ISO Abbreviation: J. Hepatol. Publication Date: 2004 Dec |
Date Detail:
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Created Date: 2004-12-07 Completed Date: 2005-05-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 1026-30 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cohort Studies Female Gastroenterology* Guidelines as Topic* / standards Hepatitis B, Chronic / therapy* Humans Male Netherlands Patient Selection Primary Health Care* Prospective Studies Public Health Referral and Consultation* Retrospective Studies |
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