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Health Services Research and Development Center, Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
Although several studies have shown that US physicians make greater use of medical technologies than UK physicians, no study has examined variation in specialty referral rates, the step before specialised procedures. We compared rates of referral to specialists in the United Kingdom and the United States. To hold the effects of gatekeeping systems constant, we studied US managed care settings that used a structured referral process similar to that in the United Kingdom.
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