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Author's report Title : Ethnic differences in use of , reasons for referrals to and diagnosis in an internal medicine outpatient clinic Version : 2 Date : 31 December 2007
| Content Provider | Semantic Scholar |
|---|---|
| Author | Fiscella, Kevin A. |
| Abstract | Background: While I agree with the premise regarding the need for health care planning to ensure equal access, it doubtful that these types of data can reliably assess inequities in access or referrals. At best, they provide preliminary data and hypotheses requiring further study. This point warrants emphasis (compulsory) Methods: The authors write in the first person to describe what they did, but need to be consistent throughout in doing so. Use of passive voice e.g. â##it was examined,â## should be avoided. (minor) Conclusions: The conclusion is relatively weak and provides more of a summary of the data than a synthesis of the findings. INTRODUCTION Pg 3, para 1. The use of the term â##consumptionâ## can be omitted when referring to rates, e.g. â##Some studies reported higher [consumption] rates by various ethnic minority groupsâ#¦â##(Minor) Pg, para 2. The second paragraph of the introduction discusses potential causes of ethnic differences in health care use. This section should be expanded beyond differences in incidence/prevalence to include ethnic differences related to symptom severity and expression, recognition and meaning, expectation for allopathic treatment, communication of symptoms to the physician and physician interpretation, treatment, and referral and patient acceptance of treatment and referral (minor) METHODS Contextual information Pg 4, para 2. Many international readers will not be familiar with the organization of health care in the Netherlands, much less in Rotterdam. The authors should provide more contextual information including costs associated with referrals, the percentage of population in Rotterdam and the surrounding referral area served by the clinic and reasons why patients and their physicians might choose once source of internal medicine care over another, e.g. transportation, language translation services, location of pharmacy, ethnicity of staff, payments etc. (minor) These data if available would facilitate more meaningful interpretation of the results. I would like to see a clearer explanation of referrals in the context of this paper. I assume the authors mean patients who are referred by community general practitioners for evaluation by internists at the Rotterdam clinic. Are all patients seen in the Erasmus medical clinic referred by general practitioners or can patients residing in the municipality of Rotterdam self refer? By inference, it appears that all patients in the sample were specifically referred by a general practitioner to Erasmus MC. This critical point requires clarification (compulsory). Population Pg 4, para 3. I would suggest listing inclusion and exclusion criteria for the study (minor) e.g. inclusion criteria 1) New patient visit to clinic between March (add day of month) 2002 and March (add day of month) 2003 (need to determine how â##newâ## patients are identified. Is a patient who had no prior visit for 5 years a new patient?) 2) Age 15 years and older (provide a rationale for starting at age 15) 3) Resident of the municipality of Rotterdam 4) Dutch or one of six ethnic groups The actual description of the population should be moved to the results section (minor). Exclusion criteria should include key missing data and any other exclusions (minor) |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://static-content.springer.com/openpeerreview/art:10.1186%2F1471-2458-8-287/12889_2007_1257_ReviewerReport_V2_R1.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Report |
