CHARACTERISTICS OF SELF-REFERRED PATIENTS

Background: This paper defines and characterizes the self-referred pat ient, and answers key questions about self-referred patients' access t o general medical and preventive care. Method. Five years of data (Jul y 1987 to June 1992) from The University of Iowa Hospitals and Clinics , a 900-bed tertiary care facility, were used to identify the demograp hics of self-referred patients. Routine data for all internal medicine patients were collected, as were questionnaire data from a sample of self-referred patients in 1991-92 from subspecialty clinics (172 patie nts) and general and emergency medicine services (136 patients). Quest ions were designed to obtain information concerning the decision for r eferral and the accessibility of general medical and preventive care. Results. Thirty-five percent of the patients obtaining care in interna l medicine were self-referred patients. This percentage increased from 26.5% to 34.5% of patients over the five-year period. More general me dicine patients (45%) self-referred than did subspecialty service pati ents (32.5%). Sixty percent of these patients did not have a primary c are physician. Almost 30% of these patients had no access to preventiv e care. Many of the self-referred patients (49%) were within an age ra nge (41-75 years) most appropriate for preventive services. Conclusion : This study characterizes a large and expanding group of self-referre d patients presenting to a university hospital for care. Many of these patients did not have a primary care physician. Thus, there are oppor tunities to improve medical and preventive care for such patients.