Table 3.

Characteristics of the Referral

CharacteristicGatekeeping ArrangementP
Yes (%)*No (%)*
Reason for referral
 Advice on diagnosis49.054.6.146
 Advice on treatment58.466.0.040
 Surgery17.917.5.890
 Nonsurgical technical procedure20.820.4.912
 Mental health counseling7.65.4.298
 Medical treatment21.218.9.503
 Patient/parent/third party request17.913.0.092
 Failed conventional therapy7.99.0.610
 Administrative renewal1.40.1.015
 Time constraints1.20.949
 Medicolegal reasons2.21.0.219
 Multidisciplinary care6.76.0.697
Health problem leading to referral
 Health problem leading to referral was a sign or symptom30.535.1.215
 Physician was very/completely certain of diagnosis60.357.6.666
Referred to surgical subspecialty48.053.6.148
Duration of referral was <3 mo36.445.2.097
  • * Proportions were adjusted for patient age and type of insurance by using multivariate logistic regression techniques. The reference population was children 1–4 years old with private insurance.

  • These categories are not mutually exclusive. Physicians could indicate more than one reason for referral.