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  1. The pediatric primary-specialty care interface : How Pediatricians refer children and adolescents to specialty care.

    Article - En anglais


    To describe how pediatricians refer patients to specialists, including frequency of referral decisions, reasons for referral, and types of referrals.


    We conducted a prospective study of visits (N=58 771) made to 142 pediatricians in a national primary care practice-based research network.

    During 20 consecutive practice days, physicians and parents completed questionnaires for referred patients, and office staff kept logs of all visits.

    Physicians used medical records to complete questionnaires 3 months after referrals were made.


    Pediatricians referred patients to specialists during 2.3% of office visits.

    Referrals made during telephone conversations with parents accounted for 27.5% of all referrals.

    The most common reason for referral was advice on diagnosis or treatment (74.3%). Referrals were made most commonly to surgical subspecialists (52.3%), followed by medical subspecialists (27.9%), nonphysicians (11.4%), and mental health practitioners (8.4%). Physicians requested a consultation or a referral with shared management in 75% of cases.

    Otitis media was the condition referred most often (9.2%). Fifty other conditions accounted for 84.3% of all referrals.


    About 1 in 40 pediatric visits result in referral.

    Getting advice from a specialist is the most common reason for referral.

    Pediatricians desire a collaborative relationship with specialists for most of their referred patients. (...)

    Mots-clés Pascal : Médecin, Pédiatrie, Spécialité médicale, Coopération, Consultation, Enquête, Enfant, Homme, Adolescent, Relation interpair

    Mots-clés Pascal anglais : Physician, Pediatrics, Medical specialty, Cooperation, Consultation, Survey, Child, Human, Adolescent, Peer relation

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0435066

    Code Inist : 002B30A05. Création : 22/03/2000.