title: If the referral fits: bridging the gap between patient and referrer requirements in a tertiary referral unit.
abstract: OBJECTIVE
  We examined the reasons for which doctors refer and patients request referral to our tertiary Mood Disorders Unit (MDU), focussing on congruence and 'fit', and the potential for more efficient use of referral resources.
  
  
  METHODS
  A postal survey of patients (n = 265 or 83% responders) and referrers (n = 156 or 94% responders) sought views regarding referral and service components. Ratings from 156 matched referrer-patient dyads were compared.
  
  
  RESULTS
  Overall, referrers and patients were satisfied with the MDU. There was disparity between what referrers sought and what patients thought were the reasons for referral, and different perceptions of the value of interventions and the amount of improvement. Congruent matched referrer-patient judgements of patient outcome were more likely to correspond with objective clinician ratings than discordant ratings. Satisfaction with MDU contact or intervention was not necessarily linked to improvement; better management of chronic depression was also valued. Referrer and patient responses to open-ended questions highlighted beneficial ingredients of referral.
  
  
  CONCLUSIONS
  There was considerable lack of fit between referrers' and patients' experience of the referral. Better communication between referrer and patients can clarify the purpose of referral and possibly lead to increased compliance with medical regimens.
authors.affiliation: Prince Henry Hospital, Little Bay, New South Wales, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Eyers
authors.forename: H
authors.initials: H
authors.lastname: Brodaty
authors.forename: G
authors.initials: G
authors.lastname: Parker
authors.forename: P
authors.initials: P
authors.lastname: Boyce
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: K
authors.initials: K
authors.lastname: Wilhelm
authors.forename: I
authors.initials: I
authors.lastname: Hickie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000523:psychology; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D016896:Treatment Outcome