IF THE REFERRAL FITS - BRIDGING THE GAP BETWEEN PATIENT AND REFERRER REQUIREMENTS IN A TERTIARY REFERRAL UNIT

Objective: We examined the reasons for which doctors refer and patient s request referral to our tertiary Mood Disorders Unit (MDU), focussin g on congruence and 'fit', and the potential for more efficient use of referral resources. Method: A postal survey of patients (n=265 or 83% responders) and referrers (n=156 or 94% responders) sought views rega rding referral and service components. Ratings from 156 matched referr er-patient dyads were compared. Results: Overall, referrers and patien ts were satisfied with the MDU. There was disparity between what refer rers sought and what patients thought were the reasons for referral, a nd different perceptions of the value of interventions and the amount of improvement. Congruent matched referrer-patient judgements of patie nt outcome were more likely to correspond with objective clinician rat ings than discordant ratings. Satisfaction with MDU contact or interve ntion was not necessarily linked to improvement; better management of chronic depression was also valued. Referrer and patient responses to open-ended questions highlighted beneficial ingredients of referral, C onclusions: There was considerable lack of fit between referrers' and patients' experience of the referral. Better communication between ref errer and patients can clarify the purpose of referral and possibly le ad to increased compliance with medical regimens.