The role of contextual factors in decision-making by General Practitioners on paediatric referral to the Emergency Department: A Discrete Choice Experiment

A General Practitioner’s (GP) decision to refer a patient to the emergency department (ED) requires consideration of a multitude of factors, and significant variation in GP referral patterns to secondary care has been recorded. This study examines the contextual factors that influence GPs when referring a paediatric patient with potentially self-limiting clinical symptoms to the ED. Utilizing a discrete choice experiment, survey data was collected from GPs in Ireland (n = 142) to elicit factors influencing this decision across five attributes: time/day of visit, repeat presentation, parents’ capacity to cope, parent requesting a referral, and access to a paediatric outpatient clinic/day unit. Using mixed logit models, all attributes were statistically significant, with repeat presentation and parents lacking the capacity to cope with a sick child identified as the strongest contextual factors leading to the decision to refer to the ED. Files explained: 1. Survey Questions.docx details the survey. 2. Ngene DCE design.ngd: Ngene™ file used to set-up the DCE. 3. Survey Data File.xlsx is the source file detailing responses to the survey. 4. Stata Data File Formatted for DCE.dta is the file formatted for the DCE for analysis Note: Data collection for a second survey for a patient with intellectual disability and limited communication skills was carried out at the same time as this survey. Data from this second study (Q4.1 – Q4.7 & Q6.1 – Q6.7) are not included in these files.The CUPID Project is funded by the Health Research Board (HRB) under the National Children's Hospital Foundation Scheme 2017 (grant number: NCHF-2017-009