title: [Referring patients with chronic renal failure: differences in referral criteria between hospitals].
abstract: OBJECTIVE
  Examining the extent to which the hospital criteria for referring patients with chronic renal failure from the GP to the specialist match the criteria in the Dutch National Transmural Agreement (LTA) for 'Chronic renal failure'.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Comparison of referral criteria in ZorgDomein ('Care Domain'), an Internet application available nationwide that facilitates referrals to medical specialists, with the criteria in the Dutch National Transmural Agreement (LTA) for 'Chronic renal failure'.
  
  
  RESULTS
  More than half of the hospitals in the Netherlands use the referral application ZorgDomein. Thirty-one hospitals in ZorgDomein have criteria for referring patients with chronic renal failure. Four referral criteria are defined in the LTA. Depending on the criterion reviewed, they could be found in the referral agreements in 8-25 of the 31 hospitals. Referral criteria that were given often deviated from the content of the LTA. In nearly half of the hospitals, the limit values of the estimated glomerular filtration rate (eGRF) for referral were higher than the values included in the LTA.
  
  
  CONCLUSIONS
  There is an undesirable variation in the referral criteria for chronic renal failure in the hospitals that use ZorgDomein. This can result in unnecessary referrals to the hospital. Medical and scientific associations, hospitals and ZorgDomein should adopt the referral criteria from the national guidelines.
authors.affiliation: Nederlands Instituut voor Onderzoek van de Gezondheidszorg (NIVEL), Utrecht, the Netherlands. l.meijer@nivel.nl
authors.forename: Loes J
authors.initials: LJ
authors.lastname: Meijer
authors.forename: François  G
authors.initials: F
authors.lastname: Schellevis
mesh_terms: D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy; D009426:Netherlands; D017410:Practice Guidelines as Topic; D012015:Reference Standards; D012017:Referral and Consultation / Q000592:standards* / Q000706:statistics & numerical data*