Is Self-Referral Associated with Higher Quality Care?

Health Services Research
Craig Evan PollackKatherine L Kahn

Abstract

To assess the extent to which patients self-refer to cancer specialists and whether self-referral is associated with better experiences and quality of care. Data from surveys and medical record abstraction collected through the Cancer Care Outcomes Research and Surveillance Consortium. Observational study of patients with lung and colorectal cancer diagnosed from 2003 through 2005 in five geographically defined regions and five integrated health care delivery systems. Multivariable logistic regression models used to assess factors associated with self-referral and propensity score-weighted doubly robust models to test the association between self-referral and experiences/quality of care. Among 5,882 patients, 9.7 percent of lung cancer patients and 14.9 percent of colorectal cancer patients self-referred to at least one cancer specialist. Black patients were less likely to self-refer than white patients (odds ratio: 0.48, 95 percent confidence interval: 0.35, 0.64); patients with high incomes (vs. low) and with a college degree (vs. non-high school graduates) were significantly more likely to self-refer. Self-referral was associated with lower ratings of overall physician communication for patients with lung cancer but, convers...Continue Reading

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Citations

Jul 23, 2020·BMC Palliative Care·Ian OlverRob Sanson-Fisher
Nov 18, 2017·Medical Care Research and Review : MCRR·Eva H DuGoffCraig Evan Pollack
Jan 1, 2021·The American Surgeon·Zachary L GentryJessica M Fazendin
Jun 24, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S M QaderiJ H W de Wilt
Aug 5, 2021·BMJ Open Quality·Kim-Lin ChiewShalini K Vinod

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