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Doctors' willingness to refer elderly patients for elective surgery
O P Ryynänen1, M Myllykangas, J Kinnunen
1Department of Community Health, University of Kuopio, Finland.
Family Practice
|June 1, 1997
Summary
Doctors are less likely to refer older patients for elective surgery. Factors like comorbidity, lifestyle, and institutionalization significantly influence referral decisions more than age alone.
Area of Science:
- Geriatric Medicine
- Surgical Referral Practices
- Healthcare Decision-Making
Background:
- Elective surgery referral patterns for elderly patients are complex.
- Understanding factors influencing physician decisions is crucial for equitable care access.
Purpose of the Study:
- To investigate the relationship between physician referral willingness for elderly patients and patient characteristics.
- To identify key factors (age, comorbidity, institutionalization, lifestyle, dementia) influencing surgical referral decisions.
Main Methods:
- A postal questionnaire survey was distributed to 837 Finnish medical doctors.
- 18 distinct patient vignettes with varied characteristics were used to assess referral decisions.
- Doctors indicated whether they would refer for surgery, opt for conservative treatment, or choose another approach.
Main Results:
- Referral rates decreased with increasing patient age.
- Healthy, home-dwelling patients aged 65-70 were most likely to be referred.
- Comorbidity, institutionalization, and smoking significantly reduced referral likelihood; dementia had a smaller impact.
Conclusions:
- Physician willingness to refer elderly patients for elective surgery is influenced by multiple factors.
- Comorbidity, living situation, and lifestyle choices play a more substantial role than chronological age in referral decisions.