Abstract

This study examined whether visits to primary care physicians (PCPs) by patients with a primary behavioral health diagnosis were more likely to be associated with referral to another physician and if so, whether the association varied by clinical condition. Using PCP visits (N=577,719,897) from the 2011-2015 National Ambulatory Medical Care Survey, the authors estimated logistic regression models of whether the probability of a referral differed between visits with and without a primary behavioral health diagnosis. Visits with primary behavioral health diagnoses were 4.3 percentage points (p<0.05) more likely than visits with other primary diagnoses to result in a referral, after the analyses controlled for patient, insurance, physician, and organizational characteristics. The probability of referral varied by behavioral health condition. Referral patterns for behavioral health diagnoses are an important component of high-quality primary care. Optimizing referral patterns is a key way to improve coordination of care and resource allocation.

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