Objectives: To test two interventions aiming at improving the compliance of primary health care physicians with an agreed-on protocol of referrals to a urology department.
Methods: Joint formative meetings (every six months) were celebrated throughout a 24-month period. Also a counseling telephone line was implemented. 18.088 referrals were analyzed. The effect of both expositions was tested comparing basal data (T0) with the performance at 6, 12, 18 and 24 months later (T1, T2, T3 and T4, respectively). An additional comparison was conducted to approach the results 1 year after the study ended (T5).
Results: 61.7% of the referrals at baseline complied with the protocol. A significant improvement was detected at T1 (compliance 73.4%, RR with respect to T0 1.19, 95% CI 1.14- 1.23). At T2, 73.7% of referrals were adequate (RR with respect to T0 1.19, 95% CI 1.15-1.24). The percent of adequate referrals at T3 remained stable (73.4%, RR with respect to T0 1.18, 95% CI 1.15-1.23). Nevertheless, adequacy of referrals by the end of the second year (T4) significantly decreased (67.3%, RR with respect to T0, 1.09, 95% CI 1.05-1.12). Adequacy at T5 was almost identical to the basal (64.4%, RR with respect to T0, 1.04 95% CI 1.04-1.07).
Conclusions: Learning activities can be effective in improving the quality of referrals from primary care to one urology department. Stopping the activities entails an immediate return to the basal standards.
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Appl Neuropsychol Child
January 2025
Department of Psychology and Neuroscience Center, Brigham Young University, Provo, USA.
Chronic stage neuropsychological assessments of children with severe TBI typically center around a referral question and focus on assessing cognitive, behavioral, and emotional functioning, making differential diagnoses, and planning treatment. When severe TBI-related neurological deficits are subtle and fall outside commonly assessed behavioral indicators, as can happen with theory of mind and social information processing, they can go unobserved and subsequently fail to be assessed. Additionally, should chronic stage cognitive, behavioral, and emotional assessment findings fall within the average to above average range, a child experiencing ongoing significant unassessed severe TBI-related subtle deficits could be mistakenly judged to have "recovered" from their injury; and to be experiencing no significant ongoing residual neurological deficits.
View Article and Find Full Text PDFAsian Pac J Cancer Prev
January 2025
Cachar Cancer Hospital and Research Center, NS Avenue, Meherpur, Silchar, Assam, India.
Objective: Cancer remains a leading cause of morbidity and mortality globally, with India experiencing a significant cancer burden. Effective population-based cancer screening is crucial for early detection and reduction of cancer-related deaths. This study aims to develop a mobile application-based Cancer Screening and Surveillance System (CSMS) to enhance the efficiency and effectiveness of population-based cancer screening by community health workers (CHWs).
View Article and Find Full Text PDFMatern Child Health J
January 2025
School of Public Health (Population Health Sciences), Mark Chaffin Ctr. for Healthy Development (Leadership in Disability), School of Public Health, Georgia State University, Atlanta, GA, USA.
Objective: To examine the odds of children aged 0-5 in center-based childcare programs receiving referrals for health screenings and developmental assessments, controlling for children's races/ethnicities and provider and program factors.
Methods: We conducted secondary analyses using the 2019 National Survey for Early Care and Education (NSECE) Center-based Provider survey. We used multivariate logistic regression models to estimate referral odds for health screenings and developmental assessments from centers without these services onsite.
Acad Emerg Med
January 2025
Department of Emergency Medicine, University of Rochester, Rochester, New York, USA.
Background: Cervical cancer (CC) is preventable. CC screening decreases CC mortality. Emergency department (ED) patients are at disproportionately high risk for nonadherence with CC screening recommendations.
View Article and Find Full Text PDFArch Dermatol Res
January 2025
Department of Dermatology, University of Rochester Medical Center, Rochester, NY, USA.
Limited urgent access to board-certified dermatologists drives patients to seek dermatologic care at urgent care centers (UCC). UCC are staffed by clinicians with comparatively limited dermatology training, often resulting in lower quality care for acute dermatology conditions. Using a retrospective cohort of 839 referrals, this study investigates health care referral outcomes for patients seeking dermatologic care at UCC.
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