RT Journal Article
SR Electronic
T1 Factors influencing general practitioners' referral to hospital of adults with presumed infective diarrhoea.
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 171
OP 174
VO 44
IS 381
A1 D Nathwani
A1 J Grimshaw
A1 R J Taylor
A1 L D Ritchie
A1 J G Douglas
A1 C C Smith
YR 1994
UL http://bjgp.org/content/44/381/171.abstract
AB 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.