MOST COMMON ADVICECOUNSELLING PROVIDED IN PUBLIC AND PRIVATE

✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✦ ✜

11.2 TYPES OF REFERRALS

In public clinics, most of the referrals were to a specialist 66.9 whereas the rest were referred to either allied health professionals 21.1 or others such as dentist and quit smoking services 12.0. Table 11.2 shows the types of specialists as well as other professionals whom the doctors referred their patients to. ‡ 0DMRULW\RIUHIHUUDOVWRVSHFLDOLVWGLGQRWVSHFLI\WKHVSHFLDOW\ ‡ 7KH QH[W WRS WZR UHIHUUDOV WR VSHFLDOLVWV ZHUH WR RSKWKDOPRORJLVWV DQG REVWHWULFV DQG gynaecology specialists 1.6. ‡ 5HIHUUDOVWRWKHDOOLHGKHDOWKSURIHVVLRQDOVZHUHPRVWRIWHQWRWKHGLHWLWLDQVQXWULWLRQLVWVDWDUDWH of 0.7 per 100 encounters, physiotherapists 0.1 per 100 encounters and optometrists 0.03 per 100 encounters. Table 11.2: Types of referrals in public clinics in 2012 Specialty Number Percentage of all referrals Percentage of referral group Rate per 100 encounters 95 CI n = 42,340 Rate per 100 diagnoses 95 CI n = 68,877 Medical specialist 1,183

66.91 100.00

2.80 2.64 - 2.96 1.72 1.62 - 1.82

1RWVSHFLÀHG 1,016 57.48 85.90 2.40 2.26 - 2.55 1.48 1.39 - 1.57 Ophthalmology 740 2.25 3.36 0.10 0.07 - 0.13 0.06 0.04 - 0.08 ENT 29 1.64 2.45 0.07 0.05 - 0.10 0.04 0.03 - 0.06 O G 27 1.55 2.31 0.07 0.04 - 0.09 0.04 0.03 - 0.06 Family medicine 24 1.37 2.05 0.06 0.04 - 0.09 0.04 0.02 - 0.05 Dermatology 11 0.64 0.96 0.03 0.01 - 0.05 0.02 0.01 - 0.03 Orthopedic 11 0.62 0.92 0.03 0.01 - 0.05 0.02 0.01 - 0.03 Rheumatology 11 0.61 0.91 0.03 0.01 - 0.05 0.02 0.01 - 0.03 Cardiology 5 0.30 0.44 0.02 0.00 - 0.03 0.01 0.00 - 0.02 Respiratory 5 0.30 0.44 0.02 0.00 - 0.03 0.01 0.00 - 0.02 Nephrology 2 0.09 0.13 0.01 0.00 - 0.02 0.01 0.00 - 0.01 Urology 1 0.08 0.12 0.01 0.00 - 0.02 0.00 0.00 - 0.01 Allied Health 374

21.14 100.00

0.89 0.80 - 0.98 0.55 0.49 - 0.60

Dietitian nutritionist 309 17.49 82.73 0.74 0.65 - 0.82 0.45 0.40 - 0.50 Physiotherapist 49 2.79 13.20 0.12 0.09 - 0.15 0.07 0.05 - 0.09 Optometrist 12 0.70 3.30 0.03 0.02 - 0.05 0.02 0.01 - 0.03 Audiologist 1 0.08 0.38 0.01 0.00 - 0.02 0.00 0.00 - 0.01 Therapist 1 0.08 0.38 0.01 0.00 - 0.02 0.00 0.00 - 0.01 Other specialty 211

11.95 100.00

0.50 0.44 - 0.57 0.31 0.27 - 0.35

Others 114 6.45 53.98 0.27 0.22 - 0.32 0.17 0.14 - 0.20 Dentist 82 4.62 38.62 0.20 0.16 - 0.24 0.12 0.10 - 0.15 Quit smoking 10 0.59 4.93 0.03 0.01 - 0.05 0.02 0.01 - 0.03 Pharmacist 5 0.30 2.48 0.02 0.00 - 0.03 0.01 0.00 - 0.02 Total referrals 1,768 100.00 -

4.18 3.99 - 4.37 2.57 2.45 - 2.69

Others include referral to other clinic, social security organisation SOCSO Note: ENT - ear, nose and throat otolaryngology; OG - obstetrics and gynaecology ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✦ ✢ In private clinics, 86.0 of the referrals were to specialist and none was referred to any of the allied health professionals. The types of referrals in private clinics are as reported in Table 11.3. ‡ ODUJH SURSRUWLRQ RI WKH UHIHUUDOV WR WKH VSHFLDOLVWV KDG QRW EHHQ VSHFLÀHG WKH W\SH RI specialty the problems were referred to. ‡ 5HIHUUDOWRRWRODU\QJRORJ\17VSHFLDOLVWPDGHXSRIWRWDOUHIHUUDOV ‡ 5HIHUUDOVWRRWKHUVHJWRSXEOLFFOLQLFGHQWLVWFRQVWLWXWHRIUHIHUUDOV Table 11.3: Types of referrals in private clinics in 2012 Specialty Number Percentage of all referrals Percentage of referral group Rate per 100 encounters 95 CI n = 99,253 Rate per 100 diagnoses 95 CI n = 120,067 Medical specialist 1398

86.01 100.00

1.41 1.34 - 1.48 1.17 1.10 - 1.23

1RWVSHFLÀHG 1361 83.75 97.37 1.37 1.30 - 1.45 1.14 1.08 - 1.20 ENT 37 2.26 2.63 0.04 0.03 - 0.05 0.03 0.02 - 0.04 Allied Health - - - - - Others 227

13.99 100.00

0.23 0.20 - 0.26 0.19 0.17 - 0.22

Others 154 9.48 67.77 0.16 0.13 - 0.18 0.13 0.11 - 0.15 Dentist 73 4.51 32.23 0.08 0.06 - 0.09 0.06 0.05 - 0.08 Total referrals 1625 100.00 -

1.64 1.56 - 1.72 1.36 1.29 - 1.42

Others include referral to public clinic Note: ENT - Ear, nose and throat otolaryngology

11.3 DIAGNOSES MOST FREQUENTLY REFERRED TO HOSPITAL

All referrals could be linked to one or multiple diagnoses per visit. The availability of this linkage enabled the analysis of the most frequently referred diagnosesproblems to hospitals and specialists. Referral to hospital was provided in management of 2,872 diagnoses. Table 11.4 shows ten diagnoses most frequently referred to hospital, which were tabulated from both public and private clinics, and presented as overall results. ‡ +LJKULVNSUHJQDQF\ZDVWKHOHDGLQJGLDJQRVHVIRUUHIHUUDOVWRKRVSLWDOZLWKRXWRIHYHU\ 100 cases being referred. ‡ 6HFRQGZDVGLDEHWHVRIZKLFKPDMRULW\RIWKRVHUHIHUUHGZHUHIHPDOHVZLWKJHVWDWLRQDOGLDEHWHV at a rate of 6.7 per 100 contacts. ‡ 1HRQDWDOMDXQGLFHRURWKHUZLVHFRGHGDV´SHULQDWDOPRUELGLW\RWKHUµZDVRQHRIWKHGLDJQRVHVZLWK most referrals at 17.0 per 100 contacts. ‡ DVHV RI VXVSHFWHG DSSHQGLFLWLV ZKLFK ZDV FRGHG XQGHU IHDU RI GLJHVWLYH GLVHDVH RWKHU KDG unsurprisingly high referrals as well with a rate of 47.2 per 100 contacts.