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Improving the effectiveness and efficiency of outpatient services: a scoping review of interventions at the primary–secondary care interface

Overview of attention for article published in Journal of Health Services Research & Policy, July 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (91st percentile)
  • High Attention Score compared to outputs of the same age and source (87th percentile)

Mentioned by

twitter
35 tweeters
facebook
1 Facebook page

Citations

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10 Dimensions

Readers on

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81 Mendeley
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Title
Improving the effectiveness and efficiency of outpatient services: a scoping review of interventions at the primary–secondary care interface
Published in
Journal of Health Services Research & Policy, July 2016
DOI 10.1177/1355819616648982
Pubmed ID
Authors

Eleanor M Winpenny, Céline Miani, Emma Pitchforth, Sarah King, Martin Roland

Abstract

Variation in patterns of referral from primary care can lead to inappropriate overuse or underuse of specialist resources. Our aim was to review the literature on strategies involving primary care that are designed to improve the effectiveness and efficiency of outpatient services. A scoping review to update a review published in 2006. We conducted a systematic literature search and qualitative evidence synthesis of studies across five intervention domains: transfer of services from hospital to primary care; relocation of hospital services to primary care; joint working between primary care practitioners and specialists; interventions to change the referral behaviour of primary care practitioners and interventions to change patient behaviour. The 183 studies published since 2005, taken with the findings of the previous review, suggest that transfer of services from secondary to primary care and strategies aimed at changing referral behaviour of primary care clinicians can be effective in reducing outpatient referrals and in increasing the appropriateness of referrals. Availability of specialist advice to primary care practitioners by email or phone and use of store-and-forward telemedicine also show potential for reducing outpatient referrals and hence reducing costs. There was little evidence of a beneficial effect of relocation of specialists to primary care, or joint primary/secondary care management of patients on outpatient referrals. Across all intervention categories there was little evidence available on cost-effectiveness. There are a number of promising interventions which may improve the effectiveness and efficiency of outpatient services, including making it easier for primary care clinicians and specialists to discuss patients by email or phone. There remain substantial gaps in the evidence, particularly on cost-effectiveness, and new interventions should continue to be evaluated as they are implemented more widely. A move for specialists to work in the community is unlikely to be cost-effective without enhancing primary care clinicians' skills through education or joint consultations with complex patients.

Twitter Demographics

The data shown below were collected from the profiles of 35 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 81 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 14 17%
Student > Master 13 16%
Unspecified 11 14%
Student > Bachelor 9 11%
Other 8 10%
Other 25 31%
Unknown 1 1%
Readers by discipline Count As %
Medicine and Dentistry 36 44%
Unspecified 14 17%
Nursing and Health Professions 10 12%
Social Sciences 3 4%
Business, Management and Accounting 3 4%
Other 14 17%
Unknown 1 1%

Attention Score in Context

This research output has an Altmetric Attention Score of 19. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 September 2017.
All research outputs
#710,638
of 12,366,144 outputs
Outputs from Journal of Health Services Research & Policy
#56
of 490 outputs
Outputs of similar age
#24,131
of 269,797 outputs
Outputs of similar age from Journal of Health Services Research & Policy
#1
of 8 outputs
Altmetric has tracked 12,366,144 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 490 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.5. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 269,797 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 91% of its contemporaries.
We're also able to compare this research output to 8 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them