Date of Award

2010

Degree Type

Thesis

Degree Name

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr. Amardeep Thind

Second Advisor

Dr. Stewart Harris

Third Advisor

Dr. Yun-Hee Choi

Abstract

Objective: Determine the referral rate and the visit and patient factors associated with specialist referral for patients with type 2 diabetes. Methods: Sample consisted of 9,443 patient-physician visits from eight family practice groups in southwestern and central Ontario. GEE was used for the regression analysis. Results: The referral rate was 3.7 referrals per 100 patient visits. The odds of referral decreased if a visit occurred with a female patient and if an ACR measurement was not available at the visit. A one year increase in the number of years with the family physician resulted in a lower odds of referral. The odds of referral increased if the patient had a specialist appointment in the previous two years, if lifestyle counseling occurred and if a neuropathy examination was performed. Conclusions: Further research should assess the influence of visit level factors on decision making. Guidelines for specialist referral should also be considered.

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