An analysis of the effect of referral initiative on patients' return

Maintaining follow-ups on referral patients is of vital concern to general practitioners. Little work has been done on the effect of referral initiative on patients' return tendencies. A study of 532 referral patients, referred by 83 general practitioners to a department of internal medicine, was conducted. Patients or families initiated 18.4% of the referrals; 81.6% were initiated by physicians. No clinical severity difference was found between patient- or physician-initiated referrals. Controlling for demographic, family, and medical payment characteristics, it was found that when the referral was initiated by the physician, patients were likely to return to both the general practitioner and the medical center. The advocacy role for referring physicians was elucidated in this study.