PMID: 2504413Jul 29, 1989Paper

General practitioners' referrals to specialist outpatient clinics. I. Why general practitioners refer patients to specialist outpatient clinics

BMJ : British Medical Journal
A CoulterM Goldacre

Abstract

There has been much concern about the wide variations in general practitioners' referral rates and the consequent implications for cost and quality of care. This has led to a call to evaluate the appropriateness and effectiveness of referrals. A collaborative audit of referrals to outpatient clinics was conducted by 127 general practitioners in 33 practices in the Oxford region. Records were kept of 18,754 referrals, which included data on diagnoses and reasons for referral. Overall, 6553 (35.4%) of the referrals were for particular treatments or operations and a further 6475 (34.9%) were for specific investigation or diagnosis. Advice on management was the main reason for referral in 2656 (14.3%) cases, and in 1719 (9.3%) cases the general practitioners wanted the consultants to take over managing their patients. Reassurance of either the general practitioner or the patient was recorded as the main reason in only 762 (4.1%) referrals. There seems to be scope for rationalising the referral process. A programme with three stages for evaluating referrals to outpatient clinics is recommended.

Citations

Feb 1, 1995·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·D A RutaI T Russell
Aug 9, 2001·Irish Journal of Medical Science·L O'TooleP Eustace
Oct 1, 1995·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·M S BenningerR D Nichols
Apr 3, 2001·BJOG : an International Journal of Obstetrics and Gynaecology·R HurskainenJ Paavonen
Dec 31, 2002·BJOG : an International Journal of Obstetrics and Gynaecology·Dawn EchlinPeter Salmon
Jul 1, 1996·Medical Education·M J DonnellyP O'Sullivan
May 25, 1991·BMJ : British Medical Journal·G A ReynoldsM O Roland
Nov 14, 1992·BMJ : British Medical Journal·F Moss, M McNicol
Sep 22, 1999·Journal of General Internal Medicine·M E Cowen, M W Zodet
Jun 24, 2004·Journal of General Internal Medicine·Kari Swarztrauber, Barbara G Vickrey
Sep 9, 2005·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·T El-ToukhyJ Erian
Jul 25, 1998·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·C Coll Capdevila
Jul 2, 2015·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Mathieu BrayJennifer Uniat
Mar 5, 2013·Semergen·J M Báez MontillaF López de Castro
Aug 31, 2010·The Journal of Pediatrics·Katharine E ZuckermanKaren Donelan
Oct 5, 2007·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Maurizio RosatiNicola Surico
Oct 1, 2004·ANZ Journal of Surgery·Russell L GruenRoss S Bailie
Dec 23, 2003·BJOG : an International Journal of Obstetrics and Gynaecology·Siobán D Harlow, Oona M R Campbell
Mar 24, 2007·Journal of Evaluation in Clinical Practice·Nick Glozier, Martin Prince
Oct 4, 2012·The Journal of Clinical Hypertension·Silvia TotaroFranco Veglio
Jul 15, 2015·Family Practice·Marie-Luise RübsamStefan Bösner
Sep 1, 2015·BMC Health Services Research·Henrik WåhlbergAnn Ragnhild Broderstad
Mar 1, 1997·Scandinavian Journal of Primary Health Care·A T VehviläinenJ K Takala
Aug 5, 2015·Health Technology Assessment : HTA·T Justin ClarkJane P Daniels
Aug 5, 2011·Journal of Cardiovascular Disease Research·Sourabh AggarwalVishal Sharma
May 10, 2017·The Journal of Laryngology and Otology·J D ConstableM Daniel
Jul 16, 2009·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A ElmardiM Hamza
Apr 1, 1990·Acta Psychiatrica Scandinavica·P TyrerJ Wadsworth
May 1, 1994·British Journal of Obstetrics and Gynaecology·H O CritchleyP A Rogers
Aug 1, 1991·British Journal of Obstetrics and Gynaecology·A CoulterA Tulloch
Mar 1, 1991·British Journal of Obstetrics and Gynaecology·M C Rees
Jul 10, 2001·Journal of Clinical Periodontology· Fardal ØG J Linden
Feb 7, 2012·Pain Practice : the Official Journal of World Institute of Pain·Donald D McGearyRobert J Gatchel
May 1, 2018·Nigerian Medical Journal : Journal of the Nigeria Medical Association·Akolade O IdowuOlumide Abiodun
Jan 30, 1999·Journal of the American Medical Informatics Association : JAMIA·E E Westberg, R A Miller

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