This paper investigates the effects of patient characteristics on frequency of referral at three group practices. Major findings are: for pediatricians, referral rate increases with patient age; among internists and general practitioners, variations in patient age, marital status, and payment source are consistently related to significant variations in referral rates. At the group with a large black clientele, blacks were referred significantly less than whites. A discussion of possible causes includes differences in medical conditions and utilization patterns as related to age and payment source, the economic burden of referral on fee-for-service patients, the social or psychological stresses on older unmarried patients, and variations by race in the patient-physician relationship. Methodological aspects of the study are presented in two technical appendices that deal with problems of estimation and tests of hypotheses used.
[1]
Taubenhaus Lj.
A study of one rural practice, 1953.
,
1955
.
[2]
A. Strauss.
Medical organization, medical care and lower income groups.
,
1969,
Social science & medicine.
[3]
I. Altman.
A Decade of Health Services.
,
1968
.
[4]
C G Sheps,et al.
Delineating episodes of medical care.
,
1967,
American journal of public health and the nation's health.
[5]
H. H. Avnet.
Physician service patterns and illness rates : a research report on medical data retrieved from insurance records
,
1967
.
[6]
M. Lerner.
Physician Service Patterns and Illness Rates
,
1968
.
[7]
E. Suchman.
Stages of illness and medical care.
,
1965,
Journal of health and human behavior.