The relationship between utilization and referral for family physicians

Little is known about the relationship between use of referral by primary care physicians and their overall utilization of medical resources. Valid arguments can be made for both direct and inverse relationships. We analyzed data from a survey of Missouri family physicians using hypothetical cases to test for significant relationships between resource utilization, access to referral, and use of referral. No significant association between these variables was found using Pearson correlation coefficients. To determine whether physician characteristics other than utilization could explain referral behavior, multiple and logistic regressions were used with several physician personal and professional background factors as independent variables. No dominant factor emerged to explain differences in referral use by physicians. We conclude that the decision to initiate the referral process is complex and not easily explained, even with the aid of sophisticated statistical techniques.