title: Specialty care referral patterns for the underserved: a study of community health centers on the South Side of Chicago.
abstract: Little is known about the primary-specialty care interface for underserved patients. In order better to understand inter-physician communication patterns in urban community health centers (CHCs), we conducted a retrospective chart review of specialty care referrals for patients from four South Side Chicago CHCs. Of the 406 identified referrals, 74% (n=301) were made from CHCs that employed referral coordinators and 64% (n=258) were made to affiliated specialists. Chart documentation of whether or not the patient attended the referred specialty visit was present for 43% (n=176) of referrals, and communication from the specialist to the referring clinician was present for 31% (n=127) of referrals. Employing CHC referral coordinators was positively associated with documented specialty clinical communication (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.1-3.2). Use of referral coordinators to facilitate care and integrating delivery systems to increase information sharing appear to improve care coordination, but further investigation is warranted.
authors.affiliation: Northwestern University, Department of Family and Community Medicine, Chicago, IL 60611, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Patrick
authors.forename: Joanna
authors.initials: J
authors.lastname: Bisgaier
authors.forename: Irma
authors.initials: I
authors.lastname: Hasham
authors.forename: Tony
authors.initials: T
authors.lastname: Navarra
authors.forename: John
authors.initials: J
authors.lastname: Hickner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002641:Chicago; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003151:Community Health Centers / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007400:Interprofessional Relations; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration; D017064:Process Assessment, Health Care; D012017:Referral and Consultation / Q000458:organization & administration / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013038:Specialization; D055815:Young Adult