Impact of the consultant's type of specialty on the number of referrals after a first consultation.

摘要

A debate is presently taking place about the respective training and roles of general internists and medical subspecialists in the provision of speciallized care in Canada. However, very little evidence is available in the literature to document expected differences in the impact of generalized and subspecialized internal medicine care on utilization of health care resources and on outcomes of care.;Our goal was to describe and compare the number of subsequent referrals for consultation to specialists, between patients referred initially to general internists, in comparison to patients referred initially to cardiologists, pneumologists, gastroenterologists, endocrinologists, or rheumatologists. We also compared measures of continuity of care and of professionnal charges between these two groups of patients, following their initial referral.;Administrative databases from the "Regie de l'assurance maladie du Quebec" were used to identify the study population and to measure the outcomes. Information on known determinants of referral, including case-mix characteristics, was gathered and included in the multivariate analysis.