Significant differences for those referred compared to those not referred were examined using the Pearson chi-square test and, if any of the expected frequencies was less than five, the Fisher exact test was used.
In the year before the start of the project, 63 out of 216 children with a psychosocial diagnosis (29) were referred, compared to 65 out of 250 (30) in the year after the start of the project and 68 out of 267 (20) a year later.
In contrast, studies by Jungers et al, Wauters et al, Steel et al, and Arora et al did not find any age differences in patients with CKD who were referred early compared to those who were referred late [ 16, 18, 23, 27].
Of the 5997 women who delivered during the study period 45 cases of maternal deaths were noted, (death rates of 6.9% versus 0.5% in referred cases compared to non-referred, p < 0.001 and 0.04% versus 0.4%, p = 1.00 respectively amongst non-adolescent and adolescent parturients).
The reasons why, for example, South Asian women with FEP are more likely to involve a GP in their care, or more likely to self-refer compared with Black African women are likely to be complex and multifactorial [ 30].
Spencer et al. attributed the gender difference to boys presenting with disruptive behaviour being referred as compared to girls with inattentive behaviour [ 22].
In the study by Jungers et al, patients with congenital kidney disease were referred earlier compared to patients with hypertensive renal disease [ 16].
This illustrates once again the higher risk in the referred population compared to the primary care population as a whole, emphasising the need to use primary care data to guide primary care decisions (Hamilton and Sharp, 2004).
In addition, gender of the physician had a significant impact on referral rates with female physicians more likely to refer patients compared to male doctors.
In a study of body oncologic CT examinations, structured reports were given significantly higher satisfaction ratings by both radiologists and referring physicians compared to "free-form" reports [ 1].
The first delay was longer among those who were referred from home compared to those who were referred from the DCs.
