Referral of chronic hepatitis B patients from primary to specialist care: Making a simple guideline work

Maria Catharina Mostert, Jan Hendrik Richardus, Robert A. De Man

Research output: Contribution to journalArticleAcademicpeer-review

35 Citations (Scopus)

Abstract

To evaluate a guideline selecting patients at the primary care level for referral to a specialist, to identify bottlenecks and subsequently implement and evaluate improvements. Retrospective patient files analysis and a prospective cohort study. The study was conducted in Municipal Public Health Service (PHS), University Medical Center. Patients diagnosed with chronic hepatitis B virus (HBV) infection were referred to the PHS. Improvement of bottlenecks were identified in the referral chain, based on the guideline. Number of patients receiving correct advice, number of patients reaching the hospital for specialist care, time between notification of the PHS and final arrival in the hospital. The guideline for the referral of chronic HBV patients appeared to be appropriate, although one-third of the selected patients was not seen by the specialist. After the intervention more HBV patients (76 versus 61%) received correct advice from the PHS, and the number of HBV patients seen by the specialist increased by 18%. The referral guideline works, yet we could improve the efficiency of the guideline increasing the proportion of eligible patients reaching specialist care. In countries where mandatory reporting of HBV infections exists this guideline can be adapted to local health systems.

Original languageEnglish
Pages (from-to)1026-1030
Number of pages5
JournalJournal of Hepatology
Volume41
Issue number6
DOIs
Publication statusPublished - Dec 2004

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