2011 Volume 11 Issue 4 Pages 241-246
The Diabetes Center of the Tokyo Women's Medical University (TWMU) was founded in 1975 and its mission is to treat diabetes in an interdisciplinary manner. To achieve its goal, regional medical cooperation was placed among its highest priorities. As an acute care hospital and a high quality university hospital, referrals from local clinics and hospitals are welcomed but when the referred patients remain with the outpatient department of the TWMU Diabetes Center no vacancies for new referrals open up. To be able to continue receiving new cases reversed referrals have become necessary.
This study describes the aggressive method that was introduced to enhance regional medical cooperation and compares referral and reversed referral rates between the Diabetes Center and the TWMU hospital as a whole over the period from 1995 to 2008. The result shows that both, referral and reversed referral rates were significantly higher in the Diabetes Center throughout the period.
According to the result of a questionnaire put to the physicians at the Diabetes Center, most doctors were well aware of the importance of regional medical cooperation. When they were asked for suggestions regarding a strategy to increase the numbers of both referrals and reversed referrals, the most frequent answer was to hold a regional medical liaison conference with referring doctors and publishing the results of such a conference in the Diabetes Center's newsletter. Also, the introduction of an improved referral letter form was recommended. On the question of how to increase reversed referrals the importance of patients' (family) education, the completion of an accurate database of referring doctors and the thorough explanation to the patient to return to the original physician when the condition stabilizes was pointed out. The utilization rate of the current database was quite high with 93%, but there were voices to further improve the database.
