Physician factors associated with outpatient palliative care referral
Outpatient palliative care can provide significant benefits to seriously ill patients, but several barriers to appropriate referrals remain. No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician b...
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| Veröffentlicht in: | Palliative medicine 2009-10, Vol.23 (7), p.608-615 |
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| creator | Ahluwalia, SC Fried, TR |
| description | Outpatient palliative care can provide significant benefits to seriously ill patients, but several barriers to appropriate referrals remain. No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician beliefs, associated with referral to palliative care. Cross-sectional study of 170 primary care physicians at Kaiser Permanente (KP), a large non-profit Health Maintenance Organisation (HMO), using a self-administered questionnaire. Of the 145 respondents, 100 (70%) reported referring any patients to the palliative care program in the prior year, with a median of 3 referrals (interquartile range 2, 6). Factors associated with referral included working at KP between 10 and 20 years as compared to |
| doi_str_mv | 10.1177/0269216309106315 |
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No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician beliefs, associated with referral to palliative care. Cross-sectional study of 170 primary care physicians at Kaiser Permanente (KP), a large non-profit Health Maintenance Organisation (HMO), using a self-administered questionnaire. Of the 145 respondents, 100 (70%) reported referring any patients to the palliative care program in the prior year, with a median of 3 referrals (interquartile range 2, 6). Factors associated with referral included working at KP between 10 and 20 years as compared to <10 years [Odds ratio [OR] 6.29 (95% confidence interval [CI] 1.38, 28.6)] and having personal experience with palliative care [OR 2.13 (95% CI 0.95, 4.976)]. None of the beliefs scales was associated with referral. Physician characteristics other than their beliefs about palliative care played a significant role in determining referral. Palliative care programs should aim to increase their visibility in the outpatient setting to increase referrals by primary care physicians. Tools that help physicians identify seriously ill patients who could benefit from palliative care may also serve to increase appropriate referrals.</description><identifier>ISSN: 0269-2163</identifier><identifier>ISSN: 1477-030X</identifier><identifier>EISSN: 1477-030X</identifier><identifier>DOI: 10.1177/0269216309106315</identifier><identifier>PMID: 19460830</identifier><identifier>CODEN: PAMDE2</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Ambulatory Care - methods ; Ambulatory Care - psychology ; Attitude of Health Personnel ; Cross-Sectional Studies ; Family Practice ; Female ; Geriatrics ; Health care ; Humans ; Male ; Medical referrals ; Medicine ; Meetings ; Middle Aged ; Outpatient treatment ; Palliative care ; Palliative Care - methods ; Palliative Care - psychology ; Patients ; Personal experiences ; Physician-Patient Relations ; Physicians ; Practice Patterns, Physicians ; Primary care ; Referral and Consultation ; Referrals ; Surveys and Questionnaires ; Symptom management</subject><ispartof>Palliative medicine, 2009-10, Vol.23 (7), p.608-615</ispartof><rights>2009 SAGE Publications</rights><rights>SAGE Publications © Oct 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-fddcb9d4f0d7047d534a7a02ccb865a6f31b5f84158ef17b6be9f1c9a78a1fd03</citedby><cites>FETCH-LOGICAL-c491t-fddcb9d4f0d7047d534a7a02ccb865a6f31b5f84158ef17b6be9f1c9a78a1fd03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0269216309106315$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0269216309106315$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,780,784,885,12846,21819,27924,27925,30999,31000,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19460830$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ahluwalia, SC</creatorcontrib><creatorcontrib>Fried, TR</creatorcontrib><title>Physician factors associated with outpatient palliative care referral</title><title>Palliative medicine</title><addtitle>Palliat Med</addtitle><description>Outpatient palliative care can provide significant benefits to seriously ill patients, but several barriers to appropriate referrals remain. No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician beliefs, associated with referral to palliative care. Cross-sectional study of 170 primary care physicians at Kaiser Permanente (KP), a large non-profit Health Maintenance Organisation (HMO), using a self-administered questionnaire. Of the 145 respondents, 100 (70%) reported referring any patients to the palliative care program in the prior year, with a median of 3 referrals (interquartile range 2, 6). Factors associated with referral included working at KP between 10 and 20 years as compared to <10 years [Odds ratio [OR] 6.29 (95% confidence interval [CI] 1.38, 28.6)] and having personal experience with palliative care [OR 2.13 (95% CI 0.95, 4.976)]. None of the beliefs scales was associated with referral. Physician characteristics other than their beliefs about palliative care played a significant role in determining referral. Palliative care programs should aim to increase their visibility in the outpatient setting to increase referrals by primary care physicians. Tools that help physicians identify seriously ill patients who could benefit from palliative care may also serve to increase appropriate referrals.</description><subject>Adult</subject><subject>Ambulatory Care - methods</subject><subject>Ambulatory Care - psychology</subject><subject>Attitude of Health Personnel</subject><subject>Cross-Sectional Studies</subject><subject>Family Practice</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Health care</subject><subject>Humans</subject><subject>Male</subject><subject>Medical referrals</subject><subject>Medicine</subject><subject>Meetings</subject><subject>Middle Aged</subject><subject>Outpatient treatment</subject><subject>Palliative care</subject><subject>Palliative Care - methods</subject><subject>Palliative Care - psychology</subject><subject>Patients</subject><subject>Personal experiences</subject><subject>Physician-Patient Relations</subject><subject>Physicians</subject><subject>Practice Patterns, Physicians</subject><subject>Primary care</subject><subject>Referral and Consultation</subject><subject>Referrals</subject><subject>Surveys and Questionnaires</subject><subject>Symptom management</subject><issn>0269-2163</issn><issn>1477-030X</issn><issn>1477-030X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kc9rFTEQx4NY7LN69ySLBz1tndlkk81FKKX-gEI9KHgLs9mkL2Xf5pnsVvrfm8d7WC1Ucgjk-5nvdzLD2CuEU0Sl3kMjdYOSg0aQHNsnbIVCqRo4_HjKVju53unH7HnONwDIQYpn7Bi1kNBxWLGLr-u7HGygqfJk55hyRTnH8jC7ofoV5nUVl3lLc3DTXG1pHIsSbl1lKbkqOe9SovEFO_I0ZvfycJ-w7x8vvp1_ri-vPn05P7usrdA4134YbK8H4WFQINTQckGKoLG272RL0nPsW98JbDvnUfWyd9qj1aQ6Qj8AP2Ef9r7bpd-4wZaeSrrZprChdGciBfOvMoW1uY63ptEoFcdi8O5gkOLPxeXZbEK2bhxpcnHJRvEClbOLevtfslW80bxTBXzzALyJS5rKGEyDquOIQhQI9pBNMecytj89I5jdKs3DVZaS13__9b7gsLsC1Hsg07W7D33U8Dc9RKd0</recordid><startdate>20091001</startdate><enddate>20091001</enddate><creator>Ahluwalia, SC</creator><creator>Fried, TR</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20091001</creationdate><title>Physician factors associated with outpatient palliative care referral</title><author>Ahluwalia, SC ; Fried, TR</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-fddcb9d4f0d7047d534a7a02ccb865a6f31b5f84158ef17b6be9f1c9a78a1fd03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Ambulatory Care - methods</topic><topic>Ambulatory Care - psychology</topic><topic>Attitude of Health Personnel</topic><topic>Cross-Sectional Studies</topic><topic>Family Practice</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Health care</topic><topic>Humans</topic><topic>Male</topic><topic>Medical referrals</topic><topic>Medicine</topic><topic>Meetings</topic><topic>Middle Aged</topic><topic>Outpatient treatment</topic><topic>Palliative care</topic><topic>Palliative Care - methods</topic><topic>Palliative Care - psychology</topic><topic>Patients</topic><topic>Personal experiences</topic><topic>Physician-Patient Relations</topic><topic>Physicians</topic><topic>Practice Patterns, Physicians</topic><topic>Primary care</topic><topic>Referral and Consultation</topic><topic>Referrals</topic><topic>Surveys and Questionnaires</topic><topic>Symptom management</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ahluwalia, SC</creatorcontrib><creatorcontrib>Fried, TR</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>British Nursing Index</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ahluwalia, SC</au><au>Fried, TR</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Physician factors associated with outpatient palliative care referral</atitle><jtitle>Palliative medicine</jtitle><addtitle>Palliat Med</addtitle><date>2009-10-01</date><risdate>2009</risdate><volume>23</volume><issue>7</issue><spage>608</spage><epage>615</epage><pages>608-615</pages><issn>0269-2163</issn><issn>1477-030X</issn><eissn>1477-030X</eissn><coden>PAMDE2</coden><abstract>Outpatient palliative care can provide significant benefits to seriously ill patients, but several barriers to appropriate referrals remain. No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician beliefs, associated with referral to palliative care. Cross-sectional study of 170 primary care physicians at Kaiser Permanente (KP), a large non-profit Health Maintenance Organisation (HMO), using a self-administered questionnaire. Of the 145 respondents, 100 (70%) reported referring any patients to the palliative care program in the prior year, with a median of 3 referrals (interquartile range 2, 6). Factors associated with referral included working at KP between 10 and 20 years as compared to <10 years [Odds ratio [OR] 6.29 (95% confidence interval [CI] 1.38, 28.6)] and having personal experience with palliative care [OR 2.13 (95% CI 0.95, 4.976)]. None of the beliefs scales was associated with referral. Physician characteristics other than their beliefs about palliative care played a significant role in determining referral. Palliative care programs should aim to increase their visibility in the outpatient setting to increase referrals by primary care physicians. Tools that help physicians identify seriously ill patients who could benefit from palliative care may also serve to increase appropriate referrals.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>19460830</pmid><doi>10.1177/0269216309106315</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0269-2163 |
| ispartof | Palliative medicine, 2009-10, Vol.23 (7), p.608-615 |
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| language | eng |
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| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); SAGE Complete A-Z List |
| subjects | Adult Ambulatory Care - methods Ambulatory Care - psychology Attitude of Health Personnel Cross-Sectional Studies Family Practice Female Geriatrics Health care Humans Male Medical referrals Medicine Meetings Middle Aged Outpatient treatment Palliative care Palliative Care - methods Palliative Care - psychology Patients Personal experiences Physician-Patient Relations Physicians Practice Patterns, Physicians Primary care Referral and Consultation Referrals Surveys and Questionnaires Symptom management |
| title | Physician factors associated with outpatient palliative care referral |
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