{"id":"https://openalex.org/W2018969952","doi":"https://doi.org/10.1136/qshc.2007.025684","title":"Interpretations of referral appropriateness by senior health managers in five PCT areas in England: a qualitative investigation","display_name":"Interpretations of referral appropriateness by senior health managers in five PCT areas in England: a qualitative investigation","publication_year":2010,"publication_date":"2010-06-01","ids":{"openalex":"https://openalex.org/W2018969952","doi":"https://doi.org/10.1136/qshc.2007.025684","mag":"2018969952","pmid":"https://pubmed.ncbi.nlm.nih.gov/20534715","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/2989159"},"language":"en","primary_location":{"id":"doi:10.1136/qshc.2007.025684","doi":"https://doi.org/10.1136/qshc.2007.025684","is_oa":true,"landing_page_url":"https://doi.org/10.1136/qshc.2007.025684","pdf_url":"https://qualitysafety.bmj.com/content/qhc/19/3/182.full.pdf","source":{"id":"https://openalex.org/S152101599","display_name":"BMJ Quality & Safety","issn_l":"1475-3898","issn":["1475-3898","1475-3901","2044-5415","2044-5423"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","fnege-3","jufo-3","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality and Safety in Health Care","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://qualitysafety.bmj.com/content/qhc/19/3/182.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5005141258","display_name":"Naomi Blundell","orcid":"https://orcid.org/0009-0000-5841-9400","observed_orcids":["https://orcid.org/0009-0000-5841-9400"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"N. Blundell","raw_affiliation_strings":["Research in Practice for Adults, Devon, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research in Practice for Adults, Devon, UK","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086633752","display_name":"Aileen Clarke","orcid":"https://orcid.org/0000-0001-8299-3146","observed_orcids":["https://orcid.org/0000-0001-8299-3146"]},"institutions":[{"id":"https://openalex.org/I39555362","display_name":"University of Warwick","ror":"https://ror.org/01a77tt86","country_code":"GB","type":"education","lineage":["https://openalex.org/I39555362"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"A. Clarke","raw_affiliation_strings":["Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK","institution_ids":["https://openalex.org/I39555362"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5020260999","display_name":"Nicholas Mays","orcid":"https://orcid.org/0000-0001-9808-8466","observed_orcids":["https://orcid.org/0000-0001-9808-8466"]},"institutions":[{"id":"https://openalex.org/I4210089966","display_name":"London School of Hygiene & Tropical Medicine","ror":"https://ror.org/00a0jsq62","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I4210089966"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"N. Mays","raw_affiliation_strings":["Health Services Research Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Services Research Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK","institution_ids":["https://openalex.org/I4210089966"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5086633752"],"corresponding_institution_ids":["https://openalex.org/I39555362"],"apc_list":null,"apc_paid":null,"fwci":2.5071,"has_fulltext":true,"cited_by_count":37,"citation_normalized_percentile":{"value":0.91053349,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":98},"biblio":{"volume":"19","issue":"3","first_page":"182","last_page":"186"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12918","display_name":"Healthcare Systems and Technology","score":0.9434000253677368,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T12918","display_name":"Healthcare Systems and Technology","score":0.9434000253677368,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13896","display_name":"Health Services Management and Policy","score":0.043800000101327896,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.0020000000949949026,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/referral-appropriateness","display_name":"referral appropriateness","score":0.9480000138282776},{"id":"https://openalex.org/keywords/surgical-care","display_name":"surgical care","score":0.7820000052452087},{"id":"https://openalex.org/keywords/health-managers","display_name":"health managers","score":0.7409999966621399},{"id":"https://openalex.org/keywords/primary-care-trusts","display_name":"primary care trusts","score":0.8769999742507935},{"id":"https://openalex.org/keywords/acute-care-hospitals","display_name":"acute care hospitals","score":0.6359999775886536},{"id":"https://openalex.org/keywords/referral-quality","display_name":"referral quality","score":0.5360000133514404},{"id":"https://openalex.org/keywords/healthcare-management","display_name":"health management","score":0.39899998903274536}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8181495666503906},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.645327091217041},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.48761191964149475},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.47973600029945374},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.4195817708969116},{"id":"https://openalex.org/C2992931291","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Patient referral","level":3,"score":0.41645708680152893},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.34638023376464844},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.32388949394226074},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.0},{"id":"https://openalex.org/C36289849","wikidata":"https://www.wikidata.org/wiki/Q34749","display_name":"Social science","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000288","descriptor_name":"Administrative Personnel","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001291","descriptor_name":"Attitude of Health Personnel","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004739","descriptor_name":"England","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007407","descriptor_name":"Interviews as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009313","descriptor_name":"National Health Programs","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D012017","descriptor_name":"Referral and Consultation","qualifier_ui":"Q000145","qualifier_name":"classification","is_major_topic":false},{"descriptor_ui":"D012017","descriptor_name":"Referral and Consultation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D013222","descriptor_name":"State Medicine","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014600","descriptor_name":"Utilization Review","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D036301","descriptor_name":"Qualitative Research","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":5,"locations":[{"id":"doi:10.1136/qshc.2007.025684","doi":"https://doi.org/10.1136/qshc.2007.025684","is_oa":true,"landing_page_url":"https://doi.org/10.1136/qshc.2007.025684","pdf_url":"https://qualitysafety.bmj.com/content/qhc/19/3/182.full.pdf","source":{"id":"https://openalex.org/S152101599","display_name":"BMJ Quality & Safety","issn_l":"1475-3898","issn":["1475-3898","1475-3901","2044-5415","2044-5423"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","fnege-3","jufo-3","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality and Safety in Health Care","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:2989159","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/2989159","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Qual Saf Health Care","raw_type":"Text"},{"id":"pmid:20534715","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/20534715","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality & safety in health care","raw_type":"Journal Article"},{"id":"pmh:oai:researchonline.lshtm.ac.uk:3444","doi":null,"is_oa":false,"landing_page_url":"https://researchonline.lshtm.ac.uk/view/creators/phsrnmay.html>;","pdf_url":null,"source":{"id":"https://openalex.org/S4306402527","display_name":"LSHTM Research Online (London School of Hygiene and Tropical Medicine)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210089966","host_organization_name":"London School of Hygiene & Tropical Medicine","host_organization_lineage":["https://openalex.org/I4210089966"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":null,"raw_type":"Article"},{"id":"pmh:oai:wrap.warwick.ac.uk:3889","doi":null,"is_oa":false,"landing_page_url":"https://doi.org/10.1136/qshc.2007.025684","pdf_url":null,"source":{"id":"https://openalex.org/S4306400665","display_name":"Warwick Research Archive Portal (University of Warwick)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I39555362","host_organization_name":"University of Warwick","host_organization_lineage":["https://openalex.org/I39555362"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":null,"raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1136/qshc.2007.025684","doi":"https://doi.org/10.1136/qshc.2007.025684","is_oa":true,"landing_page_url":"https://doi.org/10.1136/qshc.2007.025684","pdf_url":"https://qualitysafety.bmj.com/content/qhc/19/3/182.full.pdf","source":{"id":"https://openalex.org/S152101599","display_name":"BMJ Quality & Safety","issn_l":"1475-3898","issn":["1475-3898","1475-3901","2044-5415","2044-5423"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","fnege-3","jufo-3","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality and Safety in Health Care","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9391000270843506,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320311430","display_name":"London School of Hygiene and Tropical Medicine","ror":"https://ror.org/00a0jsq62"},{"id":"https://openalex.org/F4320319990","display_name":"National Institute for Health and Care Research","ror":"https://ror.org/0187kwz08"},{"id":"https://openalex.org/F4320334780","display_name":"Service Delivery and Organisation Programme","ror":"https://ror.org/0187kwz08"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W2018969952.pdf","grobid_xml":"https://content.openalex.org/works/W2018969952.grobid-xml"},"referenced_works_count":13,"referenced_works":["https://openalex.org/W202306650","https://openalex.org/W1489320201","https://openalex.org/W1544133109","https://openalex.org/W1588965071","https://openalex.org/W1969793297","https://openalex.org/W1986336970","https://openalex.org/W2019601163","https://openalex.org/W2089889400","https://openalex.org/W2119046606","https://openalex.org/W2144250600","https://openalex.org/W4234809950","https://openalex.org/W4248854933","https://openalex.org/W4285719527"],"related_works":["https://openalex.org/W2189594284","https://openalex.org/W7100120723","https://openalex.org/W2037446400","https://openalex.org/W7118601237","https://openalex.org/W4394891444","https://openalex.org/W3201755594","https://openalex.org/W2131026136","https://openalex.org/W2124608030","https://openalex.org/W2998858519","https://openalex.org/W1949549029"],"abstract_inverted_index":{"AIM:":[0],"To":[1],"explore":[2],"interpretations":[3],"of":[4,87,108,159,223,227,235,237],"\"appropriate\"":[5],"and":[6,19,30,55,62,94,99,136,157,207,225],"\"inappropriate\"":[7],"elective":[8],"referral":[9,109,142,156,164,197,228,238],"from":[10,53,239],"primary":[11,26,240],"to":[12,65,106,129,198,231,241],"secondary":[13,242],"surgical":[14,243],"care":[15,27],"among":[16],"senior":[17,50,205],"clinical":[18,54,206],"non-clinical":[20,56,208],"managers":[21,209],"in":[22,36,154,162,214],"five":[23,95],"purposively":[24],"sampled":[25],"trusts":[28],"(PCTs)":[29],"their":[31],"main":[32],"associated":[33,100],"acute":[34,101],"hospitals":[35],"the":[37,66,71,155,163,173,211,215,232],"English":[38,216],"National":[39,72],"Health":[40],"Service":[41],"(NHS).":[42],"METHODS:":[43],"Semi-structured":[44],"face-to-face":[45],"interviews":[46],"were":[47,59,90,110,167,191],"undertaken":[48,149],"with":[49,116],"managerial":[51],"staff":[52],"backgrounds.":[57],"Interviews":[58],"tape-recorded,":[60],"transcribed":[61],"analysed":[63],"according":[64],"Framework":[67],"approach":[68],"developed":[69],"at":[70,210],"Centre":[73],"for":[74,122,195],"Social":[75],"Research":[76],"using":[77],"N6":[78],"(NUD*IST6)":[79],"qualitative":[80],"data":[81],"analysis":[82],"software.":[83],"RESULTS:":[84],"Twenty-two":[85],"people":[86],"23":[88],"approached":[89],"interviewed":[91],"(between":[92],"three":[93,189,218],"respondents":[96],"per":[97],"PCT":[98],"hospital).":[102],"Three":[103],"attributes":[104,190,220],"relating":[105],"appropriateness":[107,222,236],"identified:":[111],"necessity:":[112],"whether":[113],"a":[114,131,141,196],"patient":[115,132,160],"given":[117],"characteristics":[118],"was":[119,143,170],"believed":[120],"suitable":[121],"referral;":[123],"destination":[124,224],"or":[125,128],"level:":[126],"where":[127],"whom":[130],"should":[133],"be":[134,199],"referred;":[135],"quality":[137,226],"(or":[138],"process):":[139],"how":[140],"carried":[144],"out,":[145],"including":[146],"(eg,":[147],"investigations":[148],"before":[150],"referral,":[151],"information":[152],"contained":[153],"extent":[158],"involvement":[161],"decision.":[165],"Attributes":[166],"hierarchical.":[168],"\"Necessity\"":[169],"viewed":[171],"as":[172,193,201],"most":[174],"fundamental":[175],"attribute,":[176],"followed":[177],"by":[178],"\"destination\"":[179],"and,":[180],"finally,":[181],"\"quality\".":[182],"In":[183],"general,":[184],"but":[185],"not":[186],"always,":[187],"all":[188],"perceived":[192],"necessary":[194],"defined":[200],"appropriate.":[202],"CONCLUSIONS:":[203],"For":[204],"local":[212],"level":[213],"NHS,":[217],"hierarchical":[219],"(necessity,":[221],"process)":[229],"contributed":[230],"overall":[233],"concept":[234],"care.":[244]},"counts_by_year":[{"year":2024,"cited_by_count":3},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":6},{"year":2020,"cited_by_count":3},{"year":2019,"cited_by_count":3},{"year":2018,"cited_by_count":4},{"year":2017,"cited_by_count":3},{"year":2016,"cited_by_count":1},{"year":2015,"cited_by_count":2},{"year":2014,"cited_by_count":3},{"year":2012,"cited_by_count":2}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}
