Assessing Quality of Referrals to a Community-Based Chronic Pain Clinic

Area of Science:

• Pain Medicine
• Healthcare Management

Background:

• Patients with chronic pain often have complex medical and psychiatric conditions requiring specialized care.
• Referrals to specialty pain clinics are essential but can be hindered by issues in the referral process.

Purpose of the Study:

• To analyze the quality of information in patient referrals to a community pain clinic.
• To identify characteristics of physicians whose referrals are rejected.
• To understand reasons for referral rejection and the impact on patient care.

Main Methods:

• Retrospective cross-sectional study of rejected new patient referrals (November 2021-June 2022).
• Data collected on referral rejection reasons and referring physicians using the College of Physicians and Surgeons of Ontario database.
• Analysis of referral resubmission rates and acceptance after addressing deficiencies.

Main Results:

• 120 referrals from 99 physicians (88% primary care providers) were rejected.
• Rejection reasons included inadequate information (62%) and inappropriateness (38%).
• Only 46% of rejected referrals were resubmitted and accepted; half could have been accepted with complete information.

Conclusions:

• A substantial number of pain clinic referrals, primarily from primary care providers, are rejected for preventable reasons.
• Improving referral completeness can save significant staff time and reduce patient care delays.
• Simple enhancements to the referral process can improve patient access to specialized pain management.