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How health system factors affect primary care practitioners’ decisions to refer patients for further investigation: protocol for a pan-European ecological study

Overview of attention for article published in BMC Health Services Research, May 2018
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Title
How health system factors affect primary care practitioners’ decisions to refer patients for further investigation: protocol for a pan-European ecological study
Published in
BMC Health Services Research, May 2018
DOI 10.1186/s12913-018-3170-2
Pubmed ID
Authors

Michael Harris, Gordon Taylor, The Örenäs Research Group

Abstract

There is wide variation in the overall one-year relative cancer survival rates across Europe, and this is thought to indicate national variations in stage of disease at diagnosis. However, there is little evidence to explain how different national systems influence a primary care practitioner's (PCP's) referral decisions, and how these relate to the variation in survival rates. This study investigates the health system factors that influence the thinking of PCPs when faced with patients who may have cancer, how they compare across European countries, and how they relate to national one-year relative cancer relative survival rates. An online quantitative questionnaire with closed-ended questions is used in a cross-sectional survey of 1250 PCPs in Europe, in 25 local health areas in 20 countries. Descriptive data are elicited for each country, including respondents' demographic details. An exploratory factor analysis will identify factors underlying the decision to refer patients for further investigations. Between-country variation in these factors will then be further investigated and presented as means with 95% confidence intervals. A regression model will be fitted for the vignettes using one-year relative survival as the outcome, with the proportion of PCPs opting to investigate as a single explanatory variable. Weighted regression will be used to explore which health system factors are associated with opting to investigate and with one-year relative survival. Linear correlations will be estimated between the proportions opting to investigate and national survival rates. When comparing between countries, weighted linear regression will be used to adjust for different sample sizes in each country. This study investigates which system factors affect PCPs' decisions to refer and investigate patients who may have cancer, how they compare across 20 European countries, and how these factors relate to cancer survival rates. Knowledge of the extent and variability of the health system factors that affect referral decisions will inform future health service design, policy and research.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 42 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 26%
Researcher 6 14%
Student > Bachelor 4 10%
Student > Ph. D. Student 4 10%
Student > Doctoral Student 2 5%
Other 4 10%
Unknown 11 26%
Readers by discipline Count As %
Medicine and Dentistry 12 29%
Nursing and Health Professions 6 14%
Business, Management and Accounting 3 7%
Design 3 7%
Engineering 3 7%
Other 3 7%
Unknown 12 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 09 May 2018.
All research outputs
#18,606,163
of 23,047,237 outputs
Outputs from BMC Health Services Research
#6,557
of 7,721 outputs
Outputs of similar age
#253,933
of 327,709 outputs
Outputs of similar age from BMC Health Services Research
#184
of 212 outputs
Altmetric has tracked 23,047,237 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,721 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.8. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
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 327,709 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 11th percentile – i.e., 11% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 212 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.