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Research Article

Factors influencing general practitioners' referral to hospital of adults with presumed infective diarrhoea.

D Nathwani, J Grimshaw, R J Taylor, L D Ritchie, J G Douglas and C C Smith
British Journal of General Practice 1994; 44 (381): 171-174.
D Nathwani
Department of General Practice, University of Aberdeen.
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J Grimshaw
Department of General Practice, University of Aberdeen.
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R J Taylor
Department of General Practice, University of Aberdeen.
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L D Ritchie
Department of General Practice, University of Aberdeen.
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J G Douglas
Department of General Practice, University of Aberdeen.
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C C Smith
Department of General Practice, University of Aberdeen.
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Abstract

BACKGROUND. Acute infective diarrhoea is one of the commonest reasons for admission to hospital with an infectious disease. AIM. This study set out to describe the clinical features of infective diarrhoea at the time of presentation in adults managed in the community or admitted to hospital in 1990-91, in order to try to understand the decision-making process which led to referral to hospital. METHOD. Data were collected from general practitioners by computer assisted telephone interview for 114 patients with presumed infective diarrhoea referred to the infection unit at the City Hospital, Aberdeen from all practices in the Grampian region and for 121 non-referred patients managed within seven practices. RESULTS. General practitioners appeared to use examination, investigation and referral selectively in patients presenting with diarrhoeal illness. A comparison of referred and non-referred patients identified differences in patients' reasons for consultation and the general practitioners' clinical findings, suggesting these were important in the decision to refer the patient for hospital admission. General practitioners were more likely to refer adult patients with infective diarrhoea if the patients were older, were seen at home and were more acutely unwell with fever, dehydration and abdominal tenderness. CONCLUSION. The identification of these criteria may help general practitioners to decide when to refer a patient with infective diarrhoea to hospital.

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British Journal of General Practice: 44 (381)
British Journal of General Practice
Vol. 44, Issue 381
April 1994
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Factors influencing general practitioners' referral to hospital of adults with presumed infective diarrhoea.
D Nathwani, J Grimshaw, R J Taylor, L D Ritchie, J G Douglas, C C Smith
British Journal of General Practice 1994; 44 (381): 171-174.

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Factors influencing general practitioners' referral to hospital of adults with presumed infective diarrhoea.
D Nathwani, J Grimshaw, R J Taylor, L D Ritchie, J G Douglas, C C Smith
British Journal of General Practice 1994; 44 (381): 171-174.
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Print ISSN: 0960-1643
Online ISSN: 1478-5242