IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v67y2008i1p137-146.html
   My bibliography  Save this article

What influences referrals within community palliative care services? A qualitative case study

Author

Listed:
  • Walshe, Catherine
  • Chew-Graham, Carolyn
  • Todd, Chris
  • Caress, Ann

Abstract

Evidence suggests that the utilisation of community palliative care services varies considerably according to different patient characteristics. Most literature describes this variability, but does not address why such differences exist. Exploring the processes underpinning referral making rather than simply describing the outcomes of referrals may further our understanding of this variability. The aim of this article was to investigate the influences on referral decisions made within community palliative care services. A qualitative case study strategy was adopted, studying three Primary Care Trusts in England, UK. Data collection used multiple methods (interviews, observation and documentary analysis) from multiple perspectives (including general and specialist palliative care professionals, patients, managers and commissioners). Two core influences on the way health care professionals made referral decisions are identified. First, their perception of their own role in providing palliative care; autonomous professionals make independent judgements about referrals, influenced by their expertise, workload, the special nature of palliative care and the relationship they develop with patients. Second, their perception about those to whom they may refer; professionals report needing to know about services to refer to, and then make a complex judgement about the professionals involved and what they could offer the referrer as well as the patient. These findings indicate that many more factors than an assessment of patients' clinical need affect referrals within community palliative care services. It appears that personal, inter-personal and interprofessional factors have the potential to shape referral practices. Practitioners could be more explicit about influences on decision making, and policy makers take account of these complex influences on referrals rather than just mandating change.

Suggested Citation

  • Walshe, Catherine & Chew-Graham, Carolyn & Todd, Chris & Caress, Ann, 2008. "What influences referrals within community palliative care services? A qualitative case study," Social Science & Medicine, Elsevier, vol. 67(1), pages 137-146, July.
  • Handle: RePEc:eee:socmed:v:67:y:2008:i:1:p:137-146
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(08)00161-5
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Armstrong, David, 2002. "Clinical autonomy, individual and collective: the problem of changing doctors' behaviour," Social Science & Medicine, Elsevier, vol. 55(10), pages 1771-1777, November.
    2. Grande, G. E. & Addington-Hall, J. M. & Todd, C. J., 1998. "Place of death and access to home care services: are certain patient groups at a disadvantage?," Social Science & Medicine, Elsevier, vol. 47(5), pages 565-579, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Broom, Alex & Kirby, Emma & Good, Phillip & Wootton, Julia & Adams, Jon, 2013. "The art of letting go: Referral to palliative care and its discontents," Social Science & Medicine, Elsevier, vol. 78(C), pages 9-16.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Perrotta, Manuela & Geampana, Alina, 2020. "The trouble with IVF and randomised control trials: Professional legitimation narratives on time-lapse imaging and evidence-informed care," Social Science & Medicine, Elsevier, vol. 258(C).
    2. Timmermans, Stefan & Almeling, Rene, 2009. "Objectification, standardization, and commodification in health care: A conceptual readjustment," Social Science & Medicine, Elsevier, vol. 69(1), pages 21-27, July.
    3. Noriko Morioka & Jun Tomio & Toshikazu Seto & Yoshie Yumoto & Yasuko Ogata & Yasuki Kobayashi, 2018. "Association between local-level resources for home care and home deaths: A nationwide spatial analysis in Japan," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-13, August.
    4. May, Carl & Rapley, Tim & Moreira, Tiago & Finch, Tracy & Heaven, Ben, 2006. "Technogovernance: Evidence, subjectivity, and the clinical encounter in primary care medicine," Social Science & Medicine, Elsevier, vol. 62(4), pages 1022-1030, February.
    5. Lowton, Karen, 2009. "'A bed in the middle of nowhere': Parents' meanings of place of death for adults with cystic fibrosis," Social Science & Medicine, Elsevier, vol. 69(7), pages 1056-1062, October.
    6. Higgins, Angela & Porter, Sam & O'Halloran, Peter, 2014. "General practitioners' management of the long-term sick role," Social Science & Medicine, Elsevier, vol. 107(C), pages 52-60.
    7. Nigam, Amit, 2012. "Changing health care quality paradigms: The rise of clinical guidelines and quality measures in American medicine," Social Science & Medicine, Elsevier, vol. 75(11), pages 1933-1937.
    8. Louise Hoyle & Aimee Grant, 2015. "Treatment targets in emergency departments: nurses’ views of how they affect clinical practice," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(15-16), pages 2211-2218, August.
    9. Silje Gustafsson & Irene Vikman & Stefan Sävenstedt & Jesper Martinsson, 2015. "Perceptions of needs related to the practice of self‐care for minor illness," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(21-22), pages 3255-3265, November.
    10. Wensing, Michel & Baker, Richard & Szecsenyi, Joachim & Grol, Richard AU -, 2004. "Impact of national health care systems on patient evaluations of general practice in Europe," Health Policy, Elsevier, vol. 68(3), pages 353-357, June.
    11. Adrian Jaggi & Christoph Junker & Christoph Minder, 2001. "Beeinflusst die medizinische Versorgungsstruktur den Anteil Todesfälle im Spital?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 46(6), pages 379-388, November.
    12. John Martyn Chamberlain, 2010. "Portfolio-Based Performance Appraisal for Doctors: A Case of Paperwork Compliance," Sociological Research Online, , vol. 15(1), pages 68-76, February.
    13. Sumati Ahuja, 2023. "Professional Identity Threats in Interprofessional Collaborations: A Case of Architects in Professional Service Firms," Journal of Management Studies, Wiley Blackwell, vol. 60(2), pages 428-453, March.
    14. Anthony C Waddimba & David C Mohr & Howard B Beckman & Mark M Meterko, 2020. "Physicians’ perceptions of autonomy support during transition to value-based reimbursement: A multi-center psychometric evaluation of six-item and three-item measures," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-29, April.
    15. Nigam, Amit, 2013. "How institutional change and individual researchers helped advance clinical guidelines in American health care," Social Science & Medicine, Elsevier, vol. 87(C), pages 16-22.
    16. Bourgain, Catherine & Pourtau, Lionel & Mazouni, Chafika & Bungener, Martine & Bonastre, et Julia, 2020. "Imperfect biomarkers for adjuvant chemotherapy in early stage breast cancer with good prognosis," Social Science & Medicine, Elsevier, vol. 246(C).
    17. Lambert, Helen, 2006. "Accounting for EBM: Notions of evidence in medicine," Social Science & Medicine, Elsevier, vol. 62(11), pages 2633-2645, June.
    18. Mykhalovskiy, Eric & Armstrong, Pat & Armstrong, Hugh & Bourgeault, Ivy & Choiniere, Jackie & Lexchin, Joel & Peters, Suzanne & White, Jerry, 2008. "Qualitative research and the politics of knowledge in an age of evidence: Developing a research-based practice of immanent critique," Social Science & Medicine, Elsevier, vol. 67(1), pages 195-203, July.
    19. Boutheina Fhoula & Majed Hadid & Adel Elomri & Laoucine Kerbache & Anas Hamad & Mohammed Hamad J. Al Thani & Raed M. Al-Zoubi & Abdulla Al-Ansari & Omar M. Aboumarzouk & Abdelfatteh El Omri, 2022. "Home Cancer Care Research: A Bibliometric and Visualization Analysis (1990–2021)," IJERPH, MDPI, vol. 19(20), pages 1-25, October.
    20. Cohen, Joachim & Bilsen, Johan & Hooft, Peter & Deboosere, Patrick & Wal, Gerrit van der & Deliens, Luc, 2006. "Dying at home or in an institution: Using death certificates to explore the factors associated with place of death," Health Policy, Elsevier, vol. 78(2-3), pages 319-329, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:67:y:2008:i:1:p:137-146. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.