title: Effect of ambulatory utilization review on referrals from generalists to specialists.
abstract: We studied whether ambulatory utilization review (UR) alters how many patients internal medicine residents refer to sub-specialists, and whether the effect persists without reinforcement. We compared referral rates of residents from a firm that held UR meetings (intervention firm residents, n = 20) with those of residents from a firm that did not (control firm residents, n = 21). We then compared referral rates of 17 intervention firm residents while they were participating in UR with their rates after not participating for at least 4 weeks. Intervention firm residents submitted 30% fewer referrals than control firm residents (9% vs 13%, p = .05). However, the effect was short-lived; after 4 weeks without UR, intervention firm resident referral rates were similar to control firm referral rates.
authors.affiliation: Sepulveda Veterans Administration Medical Center, Calif 91343, USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Grimm
authors.forename: A G
authors.initials: AG
authors.lastname: Gomez
mesh_terms: D000553:Ambulatory Care; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D008297:Male; D008511:Medicine; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013038:Specialization; D018709:Statistics, Nonparametric; D014600:Utilization Review