Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systemat
- PDF / 881,304 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 96 Downloads / 188 Views
RESEARCH ARTICLE
Open Access
Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systematic review and narrative synthesis Ciara Conlon1* , Emma Nicholson1, Beatriz Rodríguez-Martin2, Roisin O’Donovan1, Aoife De Brún1, Thérѐse McDonnell1, Gerard Bury3 and Eilish McAuliffe1
Abstract Background: Clinical guidelines are integral to a general practitioner’s decision to refer a paediatric patient to emergency care. The influence of non-clinical factors must also be considered. This review explores the non-clinical factors that may influence general practitioners (GPs) when deciding whether or not to refer a paediatric patient to the Emergency Department (ED). Methods: A systematic review of peer-reviewed literature published from August 1980 to July 2019 was conducted to explore the non-clinical factors that influence GPs’ decision-making in referring paediatric patients to the emergency department. The results were synthesised using a narrative approach. Results: Seven studies met the inclusion criteria. Non-clinical factors relating to patients, GPs and health systems influence GPs decision to refer children to the ED. GPs reported parents/ caregivers influence, including their perception of severity of child’s illness, parent’s request for onward referral and GPs’ appraisal of parents’ ability to cope. Socio-economic status, GPs’ aversion to risk and system level factors such as access to diagnostics and specialist services also influenced referral decisions. Conclusions: A myriad of non-clinical factors influence GP referrals of children to the ED. Further research on the impact of non-clinical factors on clinical decision-making can help to elucidate patterns and trends of paediatric healthcare and identify areas for intervention to utilise resources efficiently and improve healthcare delivery. Keywords: Decision-making, Referrals, Paediatric, Unscheduled healthcare, Non-clinical factors
Background General practitioners (GPs) are often the first point of contact to healthcare, acting as a gateway to emergency, specialist, or other secondary care services in many countries [1, 2]. Rising utilization of emergency departments * Correspondence: [email protected] 1 Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin 4, Ireland Full list of author information is available at the end of the article
(ED) has been recorded internationally, leading to increased attention to reducing demand on emergency services [3, 4]. This debate is commonly framed in terms of the appropriateness of visits, and children have been identified as high users of the ED with conditions treatable in primary care [3, 5]. GPs contribute substantially to ED attendance rates through referrals. In the UK, GP referrals account for 21% of emergency admissions annually [6], while in Australia 8% of all presentations to the ED are referred by a GP [7]. In Irel
Data Loading...
