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Understanding common reasons for patient referrals in difficult-to-access specialties

Contributor(s):
Solomon, Neil A.
California HealthCare Foundation.
Publication:
Oakland, Calif. : California HealthCare Foundation, c2009
Language(s):
English
Format:
Text
Subject(s):
Community Health Services
Health Services Accessibility
Medicine
Referral and Consultation
Specialization
Dermatology
Gastroenterology
Health Resources
Health Services Needs and Demand
Insurance, Health, Reimbursement
Interviews as Topic
Neurology
Orthopedics
Primary Health Care
Telemedicine
Humans
California
Genre(s):
Technical Report
Abstract:
It is well established that uninsured and publicly insured Californians, who generally rely on community clinics and other safety-net providers for their medical care, face significant challenges in gaining timely access to specialty care services. The many factors affecting access include low or no reimbursement, a limited supply of specialists in some geographic areas, and poor communication between primary care providers and specialists. In addition to policy-level efforts to address provider reimbursement and supply, there are significant opportunities to optimize the use of existing specialty resources in the safety net through innovative use of provider resources, technology, and new care models. This could include expanded primary care provider training to manage common presentations, the introduction of new specialty consultation methods such as telemedicine or electronic consultation, or greater use of physician extenders for common procedures or screenings, among other measures. In order to identify strategies that appropriately address specialty care needs, it is essential to clearly understand the typical clinical scenarios that generate referrals within individual specialties and the specific services or tasks that are requested. In June 2008, the California HealthCare Foundation commissioned a series of interviews with experienced primary care providers at community and public hospital clinics to address these questions and to gain greater insight into typical referral processes, identify specific challenges, and gather ideas about how to address access problems. The primary purpose of this project was to clearly describe the most common clinical presentations for safety-net clinics within difficult-to-access specialty services and discuss strategies that could lead to more optimal use of specialty resources. A secondary purpose was to provide a framework for thinking about optimizing specialty resources and initiating discussion among the provider community for developing, testing, and disseminating effective strategies.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
NLM Unique ID:
101515153 (See catalog record)
Contributor(s):
Solomon, Neil A.
California HealthCare Foundation.
Publication:
Oakland, Calif. : California HealthCare Foundation, c2009
Language(s):
English
Format:
Text
Subject(s):
Community Health Services
Health Services Accessibility
Medicine
Referral and Consultation
Specialization
Dermatology
Gastroenterology
Health Resources
Health Services Needs and Demand
Insurance, Health, Reimbursement
Interviews as Topic
Neurology
Orthopedics
Primary Health Care
Telemedicine
Humans
California
Genre(s):
Technical Report
Abstract:
It is well established that uninsured and publicly insured Californians, who generally rely on community clinics and other safety-net providers for their medical care, face significant challenges in gaining timely access to specialty care services. The many factors affecting access include low or no reimbursement, a limited supply of specialists in some geographic areas, and poor communication between primary care providers and specialists. In addition to policy-level efforts to address provider reimbursement and supply, there are significant opportunities to optimize the use of existing specialty resources in the safety net through innovative use of provider resources, technology, and new care models. This could include expanded primary care provider training to manage common presentations, the introduction of new specialty consultation methods such as telemedicine or electronic consultation, or greater use of physician extenders for common procedures or screenings, among other measures. In order to identify strategies that appropriately address specialty care needs, it is essential to clearly understand the typical clinical scenarios that generate referrals within individual specialties and the specific services or tasks that are requested. In June 2008, the California HealthCare Foundation commissioned a series of interviews with experienced primary care providers at community and public hospital clinics to address these questions and to gain greater insight into typical referral processes, identify specific challenges, and gather ideas about how to address access problems. The primary purpose of this project was to clearly describe the most common clinical presentations for safety-net clinics within difficult-to-access specialty services and discuss strategies that could lead to more optimal use of specialty resources. A secondary purpose was to provide a framework for thinking about optimizing specialty resources and initiating discussion among the provider community for developing, testing, and disseminating effective strategies.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
NLM Unique ID:
101515153 (See catalog record)