by Chong Yu Hoi. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 166-172). / Chapter 1. --- Introduction --- p.1 / Chapter 2. --- Background --- p.5 / Chapter 2.1. --- Evolution of Primary Health Care in Last TwoDecades 226}0ؤ An Overview --- p.5 / Chapter 2.2. --- Role of Primary Health Care --- p.11 / Chapter 2.3. --- Significance of Referral Between Primary and Secondary Health Care --- p.12 / Chapter 2.4. --- Attributes of Referral --- p.14 / Chapter 2.4.1. --- Referral Rate --- p.14 / Chapter 2.4.2. --- Referral Pattern --- p.19 / Chapter 2.4.3. --- Reason of Referral --- p.20 / Chapter 2.4.4. --- Appropriateness of Referral --- p.24 / Chapter 2.4.5. --- Referral Letter --- p.30 / Chapter 3. --- Situation in Hong Kong --- p.34 / Chapter 3.1. --- Health of the Society --- p.34 / Chapter 3.2. --- History of GOPC Service in Hong Kong --- p.35 / Chapter 3.3. --- Present Situation of GOPC Services --- p.37 / Chapter 3.4. --- Previous Surveys on Private Practice in Hong Kong --- p.38 / Chapter 3.5. --- Previous Surveys on GOPC Services in Hong Kong --- p.39 / Chapter 3.6. --- A Review of Data from 12 GOPCs --- p.44 / Chapter 4. --- The Study: Objectives and Method --- p.48 / Chapter 4.1. --- Objectives --- p.48 / Chapter 4.2. --- Materials & Method - The Framework of the Study --- p.51 / Chapter 4.3. --- Phase One --- p.52 / Chapter 4.3.1. --- Study Population --- p.53 / Chapter 4.3.2. --- Sampling Method --- p.53 / Chapter 4.3.3. --- Survey Method --- p.53 / Chapter 4.3.4. --- Data Analysis --- p.54 / Chapter 4.4. --- Phase Two --- p.55 / Chapter 4.4.1. --- Study population --- p.56 / Chapter 4.4.2. --- Sampling Method --- p.57 / Chapter 4.4.3. --- Survey Method --- p.57 / Chapter 4.4.4. --- Data Analysis --- p.58 / Chapter 4.5. --- Phase Three --- p.59 / Chapter 4.5.1. --- Study Population --- p.59 / Chapter 4.5.2. --- Sampling Method --- p.60 / Chapter 4.5.3. --- Survey Method --- p.60 / Chapter 4.5.4. --- Data Analysis --- p.60 / Chapter 5. --- Study Result: Phase One --- p.62 / Chapter 5.1. --- The Response Rate --- p.62 / Chapter 5.2. --- Profile of Patients --- p.63 / Chapter 5.3. --- Referral Rate --- p.64 / Chapter 5.3.1. --- The Spectrum In Hong Kong --- p.64 / Chapter 5.3.2. --- Relationship with Individual GOPC --- p.65 / Chapter 5.3.3. --- Relationship with Practice Size --- p.66 / Chapter 5.3.4. --- Relationship with the Day of the Week --- p.67 / Chapter 5.3.5. --- Relationship with Workload of the Day --- p.69 / Chapter 5.3.6. --- Relationship with Workload of Doctor --- p.70 / Chapter 5.3.7. --- Relationship with Basic Medical Training --- p.72 / Chapter 5.3.8. --- Relationship with Year of Experience --- p.73 / Chapter 5.3.9. --- Relationship with Higher Qualification --- p.73 / Chapter 5.4. --- Referral Pattern --- p.74 / Chapter 5.5. --- Reason of Referral --- p.75 / Chapter 5.6. --- Prescription Rate --- p.77 / Chapter 5.7. --- Investigation Rate --- p.78 / Chapter 5.8. --- Duration of Disease before Referral --- p.78 / Chapter 5.9. --- Number of GOPC consultation before Referral --- p.79 / Chapter 6. --- Study Result: Phase Two --- p.82 / Chapter 6.1. --- Response Rate --- p.82 / Chapter 6.2. --- Background of the Referral --- p.83 / Chapter 6.2.1. --- GOPCs of Referral --- p.83 / Chapter 6.2.2. --- Waiting Time for SOPC Appointment --- p.85 / Chapter 6.2.3. --- The patients --- p.86 / Chapter 6.3. --- Present Complaint --- p.87 / Chapter 6.3.1. --- Duration of Disease before Referral --- p.87 / Chapter 6.3.2. --- Number of GOPC Consultation before Referral --- p.89 / Chapter 6.4. --- Assessment of Referral --- p.90 / Chapter 6.4.1. --- Management of Referring Doctor --- p.90 / Chapter 6.5. --- Referrals with Inappropriate Necessity --- p.91 / Chapter 6.5.1. --- The Patients --- p.91 / Chapter 6.5.2. --- Referring GOPCs --- p.93 / Chapter 6.5.3. --- The Specialties --- p.94 / Chapter 6.5.4. --- "Diagnosis, Investigation & Treatment" --- p.95 / Chapter 6.5.5. --- Timing of Referral --- p.97 / Chapter 6.5.6. --- Duration of Present Attack --- p.97 / Chapter 6.5.7. --- Outcome of Referral --- p.97 / Chapter 6.6. --- Referrals with Inappropriate Timing --- p.98 / Chapter 6.6.1. --- The Patients --- p.98 / Chapter 6.6.2. --- The Referring GOPCs --- p.98 / Chapter 6.6.3. --- The Specialties --- p.100 / Chapter 6.6.4. --- Necessity of Referral --- p.101 / Chapter 6.6.5. --- Number of GOPC Visit before Referral --- p.101 / Chapter 6.6.6. --- Number of GOPC Visit with Specialty --- p.102 / Chapter 6.6.7. --- Duration of Disease --- p.103 / Chapter 6.6.8. --- Duration of Disease with Specialty --- p.104 / Chapter 6.6.9. --- "The Diagnosis, Number of GOPC Visit and Duration of Illness" --- p.105 / Chapter 6.6.10. --- Investigation & Treatment Prescribed --- p.107 / Chapter 6.6.11. --- Prognosis of the Referred Cases --- p.109 / Chapter 6.7. --- Referrals with Inappropriate Investigation --- p.110 / Chapter 6.7.1. --- The Patients --- p.110 / Chapter 6.7.2. --- The Referring GOPCs --- p.110 / Chapter 6.7.3. --- The Specialties --- p.112 / Chapter 6.7.4. --- The Diagnosis & Investigation --- p.113 / Chapter 6.7.5. --- Prognosis of Referral --- p.115 / Chapter 6.8. --- Referrals with Inappropriate Treatment --- p.115 / Chapter 6.8.1. --- The Patients --- p.115 / Chapter 6.8.2. --- Referring GOPC --- p.115 / Chapter 6.8.3. --- The Specialties --- p.117 / Chapter 6.8.4. --- The Diagnosis & Treatment --- p.118 / Chapter 6.8.5. --- Prognosis of the Referred Cases --- p.119 / Chapter 6.9. --- Assessment of the Referral Letter --- p.120 / Chapter 7. --- Study Result: Phase Three --- p.122 / Chapter 7.1. --- The Response Rate --- p.122 / Chapter 7.1.1. --- The GOPC Doctors --- p.122 / Chapter 7.1.2. --- The Specialists --- p.123 / Chapter 7.2. --- Profile of GOPC Doctors --- p.123 / Chapter 7.2.1. --- Years of Clinical Practice --- p.123 / Chapter 7.2.2. --- Qualification Obtained --- p.124 / Chapter 7.3. --- Profile of Specialists --- p.125 / Chapter 7.3.1. --- Years of Clinical Practice --- p.125 / Chapter 7.3.2. --- Qualification Obtained --- p.126 / Chapter 7.4. --- Workload of the Participating Doctors --- p.126 / Chapter 7.4.1. --- Number of outpatient Seen by GOPC Doctors --- p.126 / Chapter 7.4.2. --- Number of outpatient Seen by Specialists --- p.126 / Chapter 7.5. --- Referrals from GOPCs to Specialist Clinics --- p.127 / Chapter 7.5.1. --- Percentage of GOPC Cases Referred to Specialist Clinics --- p.127 / Chapter 7.5.2. --- Percentage of Specialist Cases Referred from GOPCs --- p.127 / Chapter 7.6. --- Communication between GOPC and Specialist Clinic --- p.128 / Chapter 7.6.1. --- Opinion of GOPC Doctors on Referral Letters --- p.128 / Chapter 7.6.2. --- Opinion of GOPC Doctors on Feedback from Specialists --- p.130 / Chapter 7.6.3. --- Opinion of Specialist on Referral Letters --- p.131 / Chapter 7.6.4. --- Opinion of Specialists on Their Feedback --- p.135 / Chapter 7.7. --- The Form of Feedback from Specialists --- p.136 / Chapter 7.8. --- Suggestions on Improving the Communication --- p.137 / Chapter 7.9. --- In Service Training for GOPC Doctors --- p.138 / Chapter 8 --- _ Discussion and Recommendation --- p.141 / Chapter 8.1. --- Limitations and Comments --- p.141 / Chapter 8.1.1. --- Representativeness of The Sample --- p.141 / Chapter 8.1.2. --- Response Rate --- p.141 / Chapter 8.1.3. --- Size of The Sample --- p.142 / Chapter 8.1.4. --- Short Duration of the Study --- p.142 / Chapter 8.1.5. --- Discontinuity of Phase One and Phase Two --- p.143 / Chapter 8.2. --- Discussion --- p.144 / Chapter 8.2.1. --- Referral Rate in Hong Kong --- p.145 / Chapter 8.2.2. --- Referral Pattern and Reason of Referral --- p.147 / Chapter 8.2.3. --- Appropriateness of Referrals --- p.149 / Chapter 8.2.4. --- Communication between GOPCs & SOPCs --- p.149 / Chapter 8.2.5. --- In Service Training for GOPC Doctors --- p.150 / Chapter 8.2.6. --- Waiting Time for SOPCs Appointment --- p.151 / Chapter 8.2.7. --- Prescription Rate --- p.152 / Chapter 8.2.8. --- Common Investigations Requested by Specialists --- p.153 / Chapter 8.2.9. --- Factors Associated with Referral Rates --- p.155 / Chapter 8.2.10. --- Factors Associated with Appropriateness of Referrals --- p.157 / Chapter 8.2.11. --- Factors Associated with Timing of Referrals --- p.158 / Chapter 8.3. --- Recommendation --- p.161 / Chapter 8.3.1. --- Further Study in Private Sector --- p.161 / Chapter 8.3.2. --- Further Study in Other Regions --- p.161 / Chapter 8.3.3. --- Further Study on the Appropriateness of those Non-referrals --- p.161 / Chapter 8.3.4. --- Improve Record in Specialist Clinics --- p.162 / Chapter 8.3.5. --- Upgrade of GOPC Drug Formulary --- p.162 / Chapter 8.3.6. --- Standard Referral & Feedback Form --- p.163 / Chapter 8.3.7. --- Shared Care Program between SOPCs & GOPCs --- p.163 / Chapter 8.3.8. --- Medical Record System in GOPCs --- p.163 / Chapter 8.3.9. --- Further Training for GOPC Doctors --- p.164 / Chapter 8.3.10. --- Principal Medical Officer for GOPC Service --- p.164 / Chapter 9. --- Reference --- p.166 / Chapter 10. --- Appendix --- p.173