Referral letters in oral medicine: an approach for the general dental practitioner
The aim of this study was to analyze the contents of referral letters related to clinical history and reason for consultation. A total of 236 consecutive referral letters were evaluated. Analysis of the referral letters was based on key items concerning patient identification, chief complaint, previ...
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Published in | International journal of oral and maxillofacial surgery Vol. 30; no. 5; pp. 448 - 451 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Amsterdam
Elsevier Ltd
01.10.2001
Elsevier |
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Abstract | The aim of this study was to analyze the contents of referral letters related to clinical history and reason for consultation. A total of 236 consecutive referral letters were evaluated. Analysis of the referral letters was based on key items concerning patient identification, chief complaint, previous consultation, laboratory investigation and use of drugs for the chief complaint. A database was organized (Epinfo 6.04) and the χ2test (α=0.05) was applied to the results. Of the 800 files examined, only 30% (236) had a referral letter. Of the 236 referral letters, 67% were from dentists, 22% from physicians and 11% from unidentified professionals. Patient age did not appear in 70% of the letters and the chief complaint was mentioned only in 55%. The letters had no details such as description of the oral lesion (80%), anatomical site (34%), size (99%), symptoms (83%), or period of evolution (92%). Clinical diagnosis was not included in 84% of the letters. Less than 5% of the referral letters contained information about previous consultation and laboratory investigation. The χ2test showed significant differences for all items of the referral letter. Referral letters did not satisfy minimal requirements about clinical history or reason for consultation, leading to failed communication among professionals. Based on this study, we suggest that standard letters are important to improve the quality of the letters, reducing the rate of omission of relevant items. |
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AbstractList | The aim of this study was to analyze the contents of referral letters related to clinical history and reason for consultation. A total of 236 consecutive referral letters were evaluated. Analysis of the referral letters was based on key items concerning patient identification, chief complaint, previous consultation, laboratory investigation and use of drugs for the chief complaint. A database was organized (Epinfo 6.04) and the χ2test (α=0.05) was applied to the results. Of the 800 files examined, only 30% (236) had a referral letter. Of the 236 referral letters, 67% were from dentists, 22% from physicians and 11% from unidentified professionals. Patient age did not appear in 70% of the letters and the chief complaint was mentioned only in 55%. The letters had no details such as description of the oral lesion (80%), anatomical site (34%), size (99%), symptoms (83%), or period of evolution (92%). Clinical diagnosis was not included in 84% of the letters. Less than 5% of the referral letters contained information about previous consultation and laboratory investigation. The χ2test showed significant differences for all items of the referral letter. Referral letters did not satisfy minimal requirements about clinical history or reason for consultation, leading to failed communication among professionals. Based on this study, we suggest that standard letters are important to improve the quality of the letters, reducing the rate of omission of relevant items. The aim of this study was to analyze the contents of referral letters related to clinical history and reason for consultation. A total of 236 consecutive referral letters were evaluated. Analysis of the referral letters was based on key items concerning patient identification, chief complaint, previous consultation, laboratory investigation and use of drugs for the chief complaint. A database was organized (Epinfo 6.04) and the chi2 test (alpha=0.05) was applied to the results. Of the 800 files examined, only 30% (236) had a referral letter. Of the 236 referral letters, 67% were from dentists, 22% from physicians and 11% from unidentified professionals. Patient age did not appear in 70% of the letters and the chief complaint was mentioned only in 55%. The letters had no details such as description of the oral lesion (80%), anatomical site (34%), size (99%), symptoms (83%), or period of evolution (92%). Clinical diagnosis was not included in 84% of the letters. Less than 5% of the referral letters contained information about previous consultation and laboratory investigation. The chi2 test showed significant differences for all items of the referral letter. Referral letters did not satisfy minimal requirements about clinical history or reason for consultation, leading to failed communication among professionals. Based on this study, we suggest that standard letters are important to improve the quality of the letters, reducing the rate of omission of relevant items. |
Author | Navarro, Cláudia Maria Sposto, Maria Regina Onofre, Mirian A |
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Cites_doi | 10.1136/bmj.297.6646.461 10.1038/sj.bdj.4808697 10.1136/bmj.304.6830.821 10.5694/j.1326-5377.1994.tb125869.x 10.1177/014107689008300413 10.1136/bmj.302.6785.1124 10.1136/bmj.297.6652.857-d |
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Keywords | oral medicine consultation referral letters dentist Human Survey Stomatology Dentist Physician Dentistry Public health Content analysis |
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References | Leonard, Babbs, Creed (RF7) 1990; 83 Zakrzewska (RF15) 1995; 178 Duke (RF3) 1986; March Newton, Eccles, Hutchinson (RF10) 1992; 304 Scaffardi (RF14) 1989; 39 Doleman (RF2) 1987; 4 Hart (RF6) 1989; 41 Marinker, Wilkin, Metcalfe (RF8) 1988; 297 Epstein (RF4) 1989; 41 Raven, Fleming (RF11) 1992; December Roland, Porter, Mattews, Redden, Simmonds, Bewley (RF13) 1991; 302 Grahan (RF5) 1994; 164 McAndrew, Potts, McAndrew, Adam (RF9) 1997; 182 Reilly (RF12) 1988; 297 Blaney, Pullen (RF1) 1989; 39 Epstein (10.1054/ijom.2001.0108_RF4) 1989; 41 Duke (10.1054/ijom.2001.0108_RF3) 1986; March Zakrzewska (10.1054/ijom.2001.0108_RF15) 1995; 178 Reilly (10.1054/ijom.2001.0108_RF12) 1988; 297 Doleman (10.1054/ijom.2001.0108_RF2) 1987; 4 Roland (10.1054/ijom.2001.0108_RF13) 1991; 302 Raven (10.1054/ijom.2001.0108_RF11) 1992; December Grahan (10.1054/ijom.2001.0108_RF5) 1994; 164 Hart (10.1054/ijom.2001.0108_RF6) 1989; 41 McAndrew (10.1054/ijom.2001.0108_RF9) 1997; 182 Blaney (10.1054/ijom.2001.0108_RF1) 1989; 39 Newton (10.1054/ijom.2001.0108_RF10) 1992; 304 Leonard (10.1054/ijom.2001.0108_RF7) 1990; 83 Marinker (10.1054/ijom.2001.0108_RF8) 1988; 297 Scaffardi (10.1054/ijom.2001.0108_RF14) 1989; 39 |
References_xml | – volume: 41 start-page: 177 year: 1989 end-page: 181 ident: RF4 article-title: The transformation of letter writting with information technology publication-title: Br J Hosp Med contributor: fullname: Epstein – volume: 83 start-page: 241 year: 1990 end-page: 244 ident: RF7 article-title: Psychiatric referrals within the hospital—the communication process publication-title: J R Soc Med contributor: fullname: Creed – volume: 304 start-page: 821 year: 1992 end-page: 824 ident: RF10 article-title: A communication between general practitioners and consultants: what should their letters contain? publication-title: Br Med J contributor: fullname: Hutchinson – volume: 39 start-page: 375 year: 1989 end-page: 376 ident: RF14 article-title: Study of written communication between general practitioners and a community physiotherapist publication-title: J R Coll Gen Pract contributor: fullname: Scaffardi – volume: 41 start-page: 175 year: 1989 end-page: 176 ident: RF6 article-title: What sort of letters do GPs want to receive from hospital specialists? publication-title: Br J Hosp Med contributor: fullname: Hart – volume: March start-page: 85 year: 1986 end-page: 90 ident: RF3 article-title: What a consultant wants to know from a GP publication-title: Dental Update contributor: fullname: Duke – volume: 297 start-page: 461 year: 1988 end-page: 464 ident: RF8 article-title: Referral to hospital: can we do better? publication-title: Br Med J contributor: fullname: Metcalfe – volume: 39 start-page: 67 year: 1989 ident: RF1 article-title: Communication between psychiatrists and general practitioners: what style of letters do psychiatrists prefer? publication-title: J R Coll Gen Pract contributor: fullname: Pullen – volume: 178 start-page: 180 year: 1995 end-page: 182 ident: RF15 article-title: Referral letters—how to improve them publication-title: Br Dent J contributor: fullname: Zakrzewska – volume: 182 start-page: 22 year: 1997 end-page: 25 ident: RF9 article-title: Opinions of dental consultants on the standard of referral letters in dentistry publication-title: Br Med J contributor: fullname: Adam – volume: 164 start-page: 625 year: 1994 end-page: 627 ident: RF5 article-title: Improving communication with specialists—the case of an oncology clinic publication-title: Med J Austr contributor: fullname: Grahan – volume: 4 start-page: 241 year: 1987 end-page: 244 ident: RF2 article-title: Improving communication between general practitioners and specialists publication-title: Family Practice contributor: fullname: Doleman – volume: December start-page: 438 year: 1992 end-page: 439 ident: RF11 article-title: Referral to hospital: Improving communication between the dental practitioner and hospital dental staff publication-title: Comm Dent contributor: fullname: Fleming – volume: 297 start-page: 857 year: 1988 ident: RF12 article-title: Hospital referrals [letter] publication-title: Br Med J contributor: fullname: Reilly – volume: 302 start-page: 1124 year: 1991 end-page: 1128 ident: RF13 article-title: Improving care a study of orthopaedic outpatient referrals publication-title: Br Med J contributor: fullname: Bewley – volume: 297 start-page: 461 year: 1988 ident: 10.1054/ijom.2001.0108_RF8 article-title: Referral to hospital: can we do better? publication-title: Br Med J doi: 10.1136/bmj.297.6646.461 contributor: fullname: Marinker – volume: December start-page: 438 year: 1992 ident: 10.1054/ijom.2001.0108_RF11 article-title: Referral to hospital: Improving communication between the dental practitioner and hospital dental staff publication-title: Comm Dent contributor: fullname: Raven – volume: 178 start-page: 180 year: 1995 ident: 10.1054/ijom.2001.0108_RF15 article-title: Referral letters—how to improve them publication-title: Br Dent J doi: 10.1038/sj.bdj.4808697 contributor: fullname: Zakrzewska – volume: 182 start-page: 22 year: 1997 ident: 10.1054/ijom.2001.0108_RF9 article-title: Opinions of dental consultants on the standard of referral letters in dentistry publication-title: Br Med J contributor: fullname: McAndrew – volume: 304 start-page: 821 year: 1992 ident: 10.1054/ijom.2001.0108_RF10 article-title: A communication between general practitioners and consultants: what should their letters contain? publication-title: Br Med J doi: 10.1136/bmj.304.6830.821 contributor: fullname: Newton – volume: 4 start-page: 241 year: 1987 ident: 10.1054/ijom.2001.0108_RF2 article-title: Improving communication between general practitioners and specialists publication-title: Family Practice contributor: fullname: Doleman – volume: 41 start-page: 177 year: 1989 ident: 10.1054/ijom.2001.0108_RF4 article-title: The transformation of letter writting with information technology publication-title: Br J Hosp Med contributor: fullname: Epstein – volume: March start-page: 85 year: 1986 ident: 10.1054/ijom.2001.0108_RF3 article-title: What a consultant wants to know from a GP publication-title: Dental Update contributor: fullname: Duke – volume: 39 start-page: 375 year: 1989 ident: 10.1054/ijom.2001.0108_RF14 article-title: Study of written communication between general practitioners and a community physiotherapist publication-title: J R Coll Gen Pract contributor: fullname: Scaffardi – volume: 164 start-page: 625 year: 1994 ident: 10.1054/ijom.2001.0108_RF5 article-title: Improving communication with specialists—the case of an oncology clinic publication-title: Med J Austr doi: 10.5694/j.1326-5377.1994.tb125869.x contributor: fullname: Grahan – volume: 83 start-page: 241 year: 1990 ident: 10.1054/ijom.2001.0108_RF7 article-title: Psychiatric referrals within the hospital—the communication process publication-title: J R Soc Med doi: 10.1177/014107689008300413 contributor: fullname: Leonard – volume: 39 start-page: 67 year: 1989 ident: 10.1054/ijom.2001.0108_RF1 article-title: Communication between psychiatrists and general practitioners: what style of letters do psychiatrists prefer? publication-title: J R Coll Gen Pract contributor: fullname: Blaney – volume: 302 start-page: 1124 year: 1991 ident: 10.1054/ijom.2001.0108_RF13 article-title: Improving care a study of orthopaedic outpatient referrals publication-title: Br Med J doi: 10.1136/bmj.302.6785.1124 contributor: fullname: Roland – volume: 41 start-page: 175 year: 1989 ident: 10.1054/ijom.2001.0108_RF6 article-title: What sort of letters do GPs want to receive from hospital specialists? publication-title: Br J Hosp Med contributor: fullname: Hart – volume: 297 start-page: 857 year: 1988 ident: 10.1054/ijom.2001.0108_RF12 article-title: Hospital referrals [letter] publication-title: Br Med J doi: 10.1136/bmj.297.6652.857-d contributor: fullname: Reilly |
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SubjectTerms | Biological and medical sciences Chi-Square Distribution consultation Correspondence as Topic dentist Dentistry General Practice, Dental - standards Humans Medical History Taking - standards Medical sciences Non tumoral diseases Oral Medicine Otorhinolaryngology. Stomatology Public health. Hygiene Public health. Hygiene-occupational medicine Quality Assurance, Health Care Referral and Consultation - standards referral letters Teaching. Deontology. Ethics. Legislation Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology |
Title | Referral letters in oral medicine: an approach for the general dental practitioner |
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