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Analysis of incorrect referrals to the cardiovascular surgery outpatient clinic

Ömer Faruk Rahman¹, Fevzi Ayyıldız<sup>2

1</sup>Department of Cardiovascular Surgery, Burdur State Hospital, Burdur, Türkiye
²Department of Cardiovascular Surgery, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye

Keywords: Cardiology, cardiovascular surgery, central physician appointment system, outpatient clinic, referral and consultation

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Objectives: This study aimed to determine the rate of incorrect referrals to the cardiovascular surgery outpatient clinic.

Patients and methods: This study retrospectively reviewed the electronic patient records of patients admitted to a cardiovascular surgery outpatient clinic between July 1, 2021, and December 1, 2022. Patients were categorized into the incorrect referral group and the appropriate admission group. Patients who should have initially presented to the cardiology outpatient clinic for symptoms such as palpitations, exertional chest pain, echocardiography control, and routine cardiac check-ups were classified as incorrect referrals. Age, sex, and Central Physician Appointment System usage were the other variables recorded in the study.

Results: Of the 2,675 patients (1,540 females, 1,135 males; mean age: 53.3±18.0 years; range, 5 to 97 years) evaluated in the study, 316 (11.8%) were categorized into the incorrect referral group. The rate of incorrect referral was 18.63% for patients who applied through the Central Physician Appointment System, whereas it was 4.43% for those who applied without an appointment. There was a significant relationship between the Central Physician Appointment System use and incorrect referral (p<0.001). Multivariate logistic regression model showed that both age and the use of the Central Physician Appointment System independently predicted inappropriate visits (p<0.001).

Conclusion: The Central Physician Appointment System alone is inadequate to prevent inappropriate admissions. Enhancing the role of artificial intelligence in the appointment system, improving health literacy, and simplifying branch names are potential changes that can be implemented to prevent incorrect referrals.

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