E-Posters-The Appropriateness of Referrals to a Urogynecological Practice

The Appropriateness of Referrals to a Urogynecological Practice - Rujin Ju, MD, MSCR

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The study examined the appropriateness of referrals to a urogynecology practice by comparing the impact and distress of pelvic floor disorders (PFD) between different referral groups. The researchers conducted a retrospective cohort study of new patient visits over a three-year period at an urban Midwest urogynecology practice. The subjects were allocated into four groups based on their presenting symptoms and signs to the referring provider. The hypothesis was that inappropriate referrals would have lower PFD symptom bother and impact on daily activities compared to appropriate referrals.<br /><br />The results showed that there were no significant differences in symptom bother and impact on daily activities between appropriate and inappropriate referrals. This suggests that the appropriateness of referrals to the practice cannot be determined based solely on referral documentation. The researchers suggested that misclassification bias due to incomplete documentation or lack of evaluation by referring providers may be one explanation for the presence of symptom bother and impact on daily activities in "inappropriately referred" patients.<br /><br />The study included 1716 new patient visits, with an average age of 58 years and mostly Caucasian patients. The majority of patients were referred by MD/DOs, and half of them were referred from OBGYN practices. Prior evaluation by referring providers was reported in 74% of the cases. There were no clinically significant differences in symptom bother and impact on daily activities between appropriate and inappropriate referrals.<br /><br />The researchers concluded that the chance that "inappropriate referrals" do not exist is possible but unlikely. They emphasized the need for improved referral documentation and evaluation by referring providers to ensure appropriate referrals. The study provides guidance for optimizing appropriate referrals by comparing referral variables and assessing PFD impact and distress.

Keywords

urogynecology practice

referrals

pelvic floor disorders

retrospective cohort study

new patient visits

referring provider

inappropriate referrals

PFD symptom bother

impact on daily activities

misclassification bias