Diabetes Referrals at a Veterans Administration Tertiary Facility
Who are the patients and why are they referred?
- Carolyn V. Nguyen, BS1,
- Alvin C. Powers, MD12,
- Debra L. Greenspan, APRN, BC2 and
- Tom A. Elasy, MD, MPH12
- 1Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
- 2Division of Endocrinology, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee
- Address correspondence and reprint requests to Tom A. Elasy, MD, MPH, 1161 21st Ave. South, S-1121 Medical Center, North Vanderbilt University Medical Center, Nashville, TN 37232-2587. E-mail: tom.elasy{at}vanderbilt.edu
Diabetes affects ∼20% of the 4.2 million veterans that receive health care through the Veterans Health Administration, a prevalence rate approximately three times greater than the general population rate of 6.3% (1,2). The purpose of this study is to characterize patients with diabetes that are referred to an endocrinology service at a Veterans Administration (VA) tertiary facility and to determine the reasons for referral.
RESEARCH DESIGN AND METHODS
The medical records of all patients referred to the Nashville VA endocrinology service during a 6-month period were reviewed. The consultation requests, which were electronically submitted through the Computerized Patient Record System, were received from inpatient and outpatient clinics at the Nashville VA Medical Center and from the regional care centers that it serves. Each consultation request contained specific data fields that identified the referring provider, service submitting the request, provisional diagnosis, and reason for request. From the codes entered, it was determined if the referral came from an outpatient or inpatient clinic, from a primary care or specialty clinic, and from a physician (ie., MD, DO) or midlevel provider (NP, PA, or PharmD).
The “reason for request” field allowed significant flexibility for the referring provider to include pertinent patient information and history of care to support the …
