Back to Search
Start Over
Appropriateness of referrals to a urogynecology practice
- Source :
- International Urogynecology Journal. 31:1675-1682
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- The urogynecology subspecialty relies on appropriate referrals from their referral base. We sought to provide guidance for optimizing appropriate referrals to urogynecology by comparing pre-referral characteristics between appropriate and inappropriate referrals. This retrospective cohort study examined predictors of appropriate urogynecology referrals. Appropriateness categorization was based upon pelvic floor disorder (PFD) symptoms and signs provided by the referring provider. Patients with both a PFD symptom and sign were considered “appropriate.” Patients with neither a PFD symptom nor sign were considered “inappropriate.” PFD symptoms were: vaginal bulge, voiding or defecatory dysfunction. PFD signs were: vaginal vault prolapse, urethral hypermobility, mesh/sling exposure, elevated post-void residual, positive standing stress test, abnormal urinalysis or urine culture-proven infection. Continuous and categorical data were analyzed with ANOVA and chi-square test, respectively. A logistic regression model to predict appropriateness was developed from variables identified from the bivariate analysis. Bivariate predictors of an appropriate referral for 1716 study subjects were older age, prior overactive bladder medication use, MD/DO referrer source and OBGYN, urogynecology or urology referrer specialty. Our logistic regression model correctly classified referrals as appropriate in 93.6% of cases. Age, anti-cholinergic medication use, referrer source and specialty are pre-initial visit predictors of urogynecology referral appropriateness. The predictor-generated model was successful in predicting referral appropriateness. Potential bias from information transfer issues, lack of pre-referral evaluation and referring provider unfamiliarity with urogynecology are possible reasons for inappropriate referrals and potential areas for improvement.
- Subjects :
- medicine.medical_specialty
Referral
Urology
030232 urology & nephrology
Specialty
Logistic regression
Subspecialty
Pelvic Floor Disorders
Pelvic Organ Prolapse
Urogynecology
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Referral and Consultation
Aged
Retrospective Studies
030219 obstetrics & reproductive medicine
Pelvic floor
Urinary Bladder, Overactive
business.industry
Obstetrics and Gynecology
Retrospective cohort study
medicine.disease
medicine.anatomical_structure
Overactive bladder
Emergency medicine
Female
business
Subjects
Details
- ISSN :
- 14333023 and 09373462
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- International Urogynecology Journal
- Accession number :
- edsair.doi.dedup.....0eead327639727d87182a75cef28330c
- Full Text :
- https://doi.org/10.1007/s00192-019-04100-x