Appropriateness of referrals to a urogynecology practice
| العنوان: | Appropriateness of referrals to a urogynecology practice |
|---|---|
| المؤلفون: | Anna Guanzon, Rujin Ju, Michael Heit, Onying Liu, Jacob DeWitt |
| المصدر: | International Urogynecology Journal. 31:1675-1682 |
| بيانات النشر: | Springer Science and Business Media LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | medicine.medical_specialty, Referral, Urology, 030232 urology & nephrology, Specialty, Logistic regression, Subspecialty, Pelvic Floor Disorders, Pelvic Organ Prolapse, Urogynecology, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Referral and Consultation, Aged, Retrospective Studies, 030219 obstetrics & reproductive medicine, Pelvic floor, Urinary Bladder, Overactive, business.industry, Obstetrics and Gynecology, Retrospective cohort study, medicine.disease, medicine.anatomical_structure, Overactive bladder, Emergency medicine, Female, business |
| الوصف: | The urogynecology subspecialty relies on appropriate referrals from their referral base. We sought to provide guidance for optimizing appropriate referrals to urogynecology by comparing pre-referral characteristics between appropriate and inappropriate referrals. This retrospective cohort study examined predictors of appropriate urogynecology referrals. Appropriateness categorization was based upon pelvic floor disorder (PFD) symptoms and signs provided by the referring provider. Patients with both a PFD symptom and sign were considered “appropriate.” Patients with neither a PFD symptom nor sign were considered “inappropriate.” PFD symptoms were: vaginal bulge, voiding or defecatory dysfunction. PFD signs were: vaginal vault prolapse, urethral hypermobility, mesh/sling exposure, elevated post-void residual, positive standing stress test, abnormal urinalysis or urine culture-proven infection. Continuous and categorical data were analyzed with ANOVA and chi-square test, respectively. A logistic regression model to predict appropriateness was developed from variables identified from the bivariate analysis. Bivariate predictors of an appropriate referral for 1716 study subjects were older age, prior overactive bladder medication use, MD/DO referrer source and OBGYN, urogynecology or urology referrer specialty. Our logistic regression model correctly classified referrals as appropriate in 93.6% of cases. Age, anti-cholinergic medication use, referrer source and specialty are pre-initial visit predictors of urogynecology referral appropriateness. The predictor-generated model was successful in predicting referral appropriateness. Potential bias from information transfer issues, lack of pre-referral evaluation and referring provider unfamiliarity with urogynecology are possible reasons for inappropriate referrals and potential areas for improvement. |
| تدمد: | 1433-3023 0937-3462 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0eead327639727d87182a75cef28330c https://doi.org/10.1007/s00192-019-04100-x |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....0eead327639727d87182a75cef28330c |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14333023 09373462 |
|---|