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The association between general practitioner participation in joint teleconsultations and rates of referral: a discrete choice experiment

Overview of attention for article published in BMC Family Practice, April 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (75th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (56th percentile)

Mentioned by

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7 tweeters

Citations

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7 Dimensions

Readers on

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117 Mendeley
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Title
The association between general practitioner participation in joint teleconsultations and rates of referral: a discrete choice experiment
Published in
BMC Family Practice, April 2015
DOI 10.1186/s12875-015-0261-6
Pubmed ID
Authors

Tiago Cravo Oliveira, James Barlow, Steffen Bayer

Abstract

Joint consultations - such as teleconsultations - provide opportunities for continuing education of general practitioners (GPs). It has been reported this form of interactive case-based learning may lead to fewer GP referrals, yet these studies have relied on expert opinion and simple frequencies, without accounting for other factors known to influence referrals. We use a survey-based discrete choice experiment of GPs' referral preferences to estimate how referral rates are associated with participation in joint teleconsultations, explicitly controlling for a number of potentially confounding variables. We distributed questionnaires at two meetings of the Portuguese Association of General Practice. GPs were presented with descriptions of patients with dermatological lesions and asked whether they would refer based on the waiting time, the distance to appointment, and pressure from patients for a referral. We analysed GPs' responses to multiple combinations of these factors, coupled with information on GP and practice characteristics, using a binary logit model. We estimated the probabilities of referral of different lesions using marginal effects. Questionnaires were returned by 44 GPs, giving a total of 721 referral choices. The average referral rate for the 11 GPs (25%) who had participated in teleconsultations was 68.1% (range 53-88%), compared to 74.4% (range 47-100%) for the remaining physicians. Participation in teleconsultations was associated with reductions in the probabilities of referral of 17.6% for patients presenting with keratosis (p = 0.02), 42.3% for psoriasis (p < 0.001), 8.4% for melanoma (p = 0.14), and 5.4% for naevus (p = 0.19). The results indicate that GP participation in teleconsultations is associated with overall reductions in referral rates and in variation across GPs, and that these effects are robust to the inclusion of other factors known to influence referrals. The reduction in range, coupled with different effects for different clinical presentations, may suggest an educational effect. However, more research is needed to establish whether there are causal relationships between participation in teleconsultations, continuing education, and referral rates.

Twitter Demographics

The data shown below were collected from the profiles of 7 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 117 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 1 <1%
Unknown 116 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 23 20%
Student > Ph. D. Student 13 11%
Student > Bachelor 13 11%
Student > Doctoral Student 9 8%
Researcher 9 8%
Other 22 19%
Unknown 28 24%
Readers by discipline Count As %
Medicine and Dentistry 33 28%
Nursing and Health Professions 16 14%
Social Sciences 9 8%
Business, Management and Accounting 5 4%
Economics, Econometrics and Finance 5 4%
Other 17 15%
Unknown 32 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. 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 25 July 2016.
All research outputs
#5,519,822
of 22,800,560 outputs
Outputs from BMC Family Practice
#576
of 1,856 outputs
Outputs of similar age
#64,726
of 265,398 outputs
Outputs of similar age from BMC Family Practice
#14
of 32 outputs
Altmetric has tracked 22,800,560 research outputs across all sources so far. Compared to these this one has done well and is in the 75th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,856 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.6. This one has gotten more attention than average, scoring higher than 68% 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 265,398 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 75% of its contemporaries.
We're also able to compare this research output to 32 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 56% of its contemporaries.