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Table 4 The CME-M impact on urgent referral rates

From: Impact of a continuing medical education meeting on the use and timing of urgent cancer referrals among general practitioners - a before-after study

 

Reference group

CME-M group

Comparison between groups

 

Before CME-M

After CME-M

Before vs. after

Before CME-M

After CME-M

Before vs. after

   
  

∆0

IRR0b (95% CI)

P

 

∆1

IRR1b (95% CI)

P

∆1/∆0

IRR1/IRR0b

(95% CI)

P

All data, N practices (GPs)

248 (425)

-

  

148 (385)

-

-

 

-

 

-

Referral ratea per GP, mean

20.4

20.8

0.4

1.02c (0.98;1.05)

0.316

20.6

21.4

0.8

1.05 c (1.01;1.08)

0.009

2.0

1.03c (0.98;1.08)

0.214

Referral ratea per 1000 patients, mean

25.0

25.3

0.3

1.01c (0.98;1.05)

0.435

27.1

28.1

1.0

1.04c (0.99;1.08)

0.111

3.3

1.02c (0.97;1.08)

0.454

Single-handed practices,

N practices (GPs)

149 (149)

-

  

45 (45)

-

-

 

-

 

-

Referral ratea per GP, mean

21.3

21.7

0.4

1.02 (0.96;1.08)

0.481

24.0

23.9

−0.1

0.99 (0.89;1.09)

0.796

−0.25

0.97 (0.86;1.08)

0.566

Referral ratea per 1000 patients, mean

24.2

24.3

0.1

1.01 (0.95;1.07)

0.763

26.9

26.2

−0.7

0.98 (0.88;1.08)

0.626

−7.0

0.97 (0.86;1.09)

0.567

Partnership practices,

N practices (GPs)

99 (276)

-

  

103 (340)

-

-

 

-

 

-

Referral ratea per GP, mean

18.9

19.3

0.4

1.02 (0.97;1.05)

0.540

19.0

20.2

1.2

1.06 (1.02;1.10)

0.002

3.0

1.04 (0.99;1.10)

0.105

Referral ratea per 1000 patients, mean

26.3

26.9

0.6

1.02 (0.97;1.08)

0.457

27.2

28.9

1.7

1.06 (1.01;1.12)

0.019

2.8

1.04 (0.97;1.12)

0.280

  1. Indirectly age-sex standardised referral rates for 6 months before and after CME-M, respectively, are shown for 1000 patients (age ≥ 40 yrs.) per practice and per GP in the practice. Practices are divided into CME-M group and reference group. The referral rates are further stratified on practice type. The effect within a group is shown as an incidence rate ratio (IRR0: Reference group; IRR1: CME-M group). Comparisons between groups are shown as the ratio of the incidence rate ratios
  2. Abbreviations: CME-M continuing medical education meeting, GP general practitioner, IRR incidence rate ratio, CI confidence interval
  3. aIndirectly age-sex standardised
  4. bAdjusted for cluster and Danish Deprivation index
  5. cIn addition, adjusted for practice type
  6. Bold = significance level of p ≤ 0.05