Patient characteristics (n = 776 referred patients)* |
Age |
0–19 y | 70 | 9.0 |
20–39 y | 179 | 23.1 |
40–49 y | 146 | 18.8 |
50–59 y | 133 | 17.2 |
60–69 y | 120 | 15.5 |
≥ 70 y | 127 | 16.4 |
Sex |
Male | 311 | 40.1 |
Female | 465 | 59.9 |
Patient/parent education |
Less than high school degree | 121 | 15.6 |
High school or some college | 374 | 48.2 |
College or technical school graduate | 207 | 26.7 |
Graduate or professional degree | 74 | 9.5 |
Annual family income |
<$20,000 | 215 | 30.7 |
$20,000–$40,000 | 218 | 31.1 |
$40,000–$60,000 | 123 | 17.5 |
>$60,000 | 145 | 20.7 |
Patient race |
White | 693 | 91.8 |
Nonwhite | 62 | 8.2 |
Health plan characteristics |
Health plan payer (n = 648) |
Private | 408 | 63.0 |
Medicaid | 71 | 11.0 |
Medicare | 145 | 22.3 |
Uninsured | 24 | 3.7 |
Gatekeeping and primary care payment type (n=630) |
No gatekeeping | 294 | 46.7 |
Gatekeeping with fee-for-service payment | 177 | 28.1 |
Gatekeeping with capitated payment | 159 | 25.2 |
Referral decision characteristics (n = 776 referrals) |
Type of specialist referred to |
Medical subspecialist | 259 | 33.4 |
Surgical subspecialist | 362 | 46.6 |
Obstetrician/gynecologist | 34 | 4.4 |
Nonphysician clinician | 89 | 11.5 |
Mental health professional | 32 | 4.1 |
Primary expectation of specialist |
Consultation for advice | 81 | 10.6 |
Perform a test or procedure | 385 | 50.3 |
Shared responsibility for ongoing management | 220 | 28.7 |
Transferred responsibility for ongoing management | 80 | 10.4 |
Expected duration of specialist involvement |
<3 mo | 493 | 64.0 |
3–12 mo | 173 | 22.5 |
>12 mo | 104 | 13.5 |
Urgency of referral—how soon patient should see specialist |
<1 wk | 265 | 34.6 |
1 wk – 1 mo | 406 | 52.9 |
At the patient’s discretion | 96 | 12.5 |
Duration of relationship with referring physician |
<3 mo | 92 | 12.0 |
3 mo – 5 y | 295 | 38.5 |
≥5 y | 379 | 49.5 |
Referring physician/staff scheduled specialist appointment |
No | 163 | 21.2 |
Yes | 605 | 78.8 |
Referring physician gave patient the name of a specialist |
No | 87 | 11.3 |
Yes | 686 | 88.7 |
Referring physician transferred patient information to specialist |
No | 113 | 14.7 |
Yes | 655 | 85.3 |
Referring physician characteristics (n = 133 physicians) |
Years in practice |
<5 y | 28 | 21.1 |
6–14 y | 38 | 28.6 |
≥15 y | 67 | 50.4 |
Sex |
Male | 106 | 79.7 |
Female | 27 | 20.3 |
Specialty |
Family physician | 123 | 92.5 |
General internist | 10 | 7.5 |
Referring practice characteristics (n = 81) |
Location |
Urban | 67 | 84.8 |
Rural | 12 | 15.2 |
US census division |
Northeast | 12 | 14.8 |
Midwest | 28 | 34.6 |
South | 24 | 29.6 |
West | 17 | 21.0 |
Size |
Solo, 2- to 3-physician practice | 30 | 37.0 |
Large practice (>3 physicians) | 51 | 63.0 |