Patient-Level Determinants of PCP-to-Specialist First-Visit Communication

OR (95% CI)POR (95% CI)P
Age of child, y1.01 (0.95–1.07).82
Male gender of child0.98 (0.52–1.84).94
Education level of parent
    High school or lessReference
    Some college1.08 (0.55–2.15).81
    College graduate or higher1.25 (0.66–2.38).49
Chronic condition (by QUICCC-R)
    Present0.99 (0.49–2.00).98
    1 or more0.67 (0.36–1.27).22
Presence of other conditions
    No other conditionsReference
    1 or more other conditions0.93 (0.47–1.80).82
Other specialists seen in past year
    No other specialistsReference
    1 or more other specialists0.40 (0.21–0.76).0050.29 (0.14–0.63).002
No. of visits to index specialty in 6 mo
    >11.64 (0.86–3.11).13NS
Specialty to which referred
    Endocrinology1.85 (0.76–4.53).18NS
    Pulmonary0.12 (0.04–0.36).00020.08 (0.03–0.28)<.0001
    Cardiology0.42 (0.12–1.43).160.26 (0.07–0.99).05
    Neurology1.80 (0.81–4.01).15NS
Insurance type
    Medicaid0.41 (0.17–0.98).040.31 (0.12–0.81).02
Referral required for specialty visit (“gatekeeping”)
    Yes1.04 (0.49–2.21).92
  • ORs are given for the outcome of cases for which communication was reported as compared with cases for which no communication was reported. Bivariate followed by forward stepwise logistic regression was used. CI indicates confidence interval; NS, not significant.