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Choosing a specialist: will patients vote with their feet (and wallets) for person-centered care?

Joseph-Williams, Natalie ORCID:, Davies, Freya ORCID:, Wood, Fiona Claire ORCID: and Edwards, Adrian G. ORCID: 2015. Choosing a specialist: will patients vote with their feet (and wallets) for person-centered care? Medical Decision Making 35 (6) , pp. 688-690. 10.1177/0272989X15583267

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A referral to a specialist is a routine decision made by physicians across different health care systems, and several factors influence this decision. Exact referral rates vary between countries, but are in the region of from 1 in 10 to 1 in 20 consultations.1,2 Researchers, policy makers, and others have long sought to understand referral patterns due to the economic, quality, and safety consequences of inappropriate referrals, and the inequalities in health and health care that arise.3⇓–5 How much is this decision to refer a collaborative decision between physicians and patients? If we want to encourage patients to become key decision makers in their treatment and care, their preferences also need to be considered during upstream processes such as referral decisions. Referral management interventions and systems have been developed and tested.6,7 Variation in referral rates might reflect factors such as age or socioeconomic circumstances, with older and more deprived patients at a disadvantage.8 Studies have also focused on primary care physician–related factors that might influence referral decisions, such as past experiences with the specialist, perceived clinical expertise, ability to coordinate care locally, physician–specialist communication, and likelihood of good patient–specialist rapport.9,10 Despite growing advocacy at the clinical and policy levels worldwide for patient-centered care pathways,

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RA Public aspects of medicine
Publisher: SAGE
ISSN: 0272-989X
Last Modified: 18 Jul 2023 22:08

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