title: Referral patterns between the child health service, general practitioners, and secondary healthcare: a prospective descriptive study in the Netherlands.
abstract: BACKGROUND
  In the Netherlands, preventive child health service (CHS) screening plays an important role in the early detection of congenital, developmental, physical, and mental disorders.
  
  
  OBJECTIVE
  To obtain insight into the referral patterns of children from CHS to general practitioners and from general practitioners to medical specialists.
  
  
  METHODS
  Prospective study over 6 months in a semi-urban area in the Netherlands. All correspondence from the participating doctors was sticker marked and, after each contact, a registration card was sent to a central secretariat. The referral stream between general practitioners and specialists or allied health professionals was extracted from a central database. The general practitioners and the participating paediatricians were asked to complete a questionnaire about the quality and necessity of the referral.
  
  
  RESULTS
  Out of an estimated 2600 examinations, 45 children were referred to their general practitioners for further examination. The problems of eight children were settled by the GP, 10 children were referred to allied health professionals, and 24 children were referred to specialists. The median time span of showing up at the GP's office was 6.5 days. Sixteen per cent showed up long after having been referred by the CHS. The parents of three children did not comply. Of the 397 referrals from GPs to medical specialists and allied health professionals, 8.5% were initiated by the CHS.
  
  
  CONCLUSIONS
  The amount of referrals from the CHS to GPs and of referrals from GPs to medical specialists and allied health professionals initiated by the CHS is low in terms of absolute percentages. Most referrals by the CHS were considered useful.
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.
authors.forename: Rubin
authors.initials: R
authors.lastname: Einhorn
authors.forename: Just A H
authors.initials: JA
authors.lastname: Eekhof
authors.forename: Adele C
authors.initials: AC
authors.lastname: Engelberts
authors.forename: Ymte
authors.initials: Y
authors.lastname: Groeneveld
authors.forename: Paul H
authors.initials: PH
authors.lastname: Verkerk
authors.forename: Jan M
authors.initials: JM
authors.lastname: Wit
mesh_terms: D000488:Allied Health Personnel / Q000706:statistics & numerical data; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis; D005194:Family Practice; D030342:Genetic Diseases, Inborn / Q000175:diagnosis; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008511:Medicine / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013038:Specialization