Taggarshe Deepa, Haldipur Nandan, Singh Sewa
Department of Surgery, Doncaster Royal Infirmary, Armthorpe Road, Doncaster DN2 5LT, UK.
J Public Health (Oxf). 2006 Sep;28(3):218-20. doi: 10.1093/pubmed/fdl027. Epub 2006 Jul 10.
Generic general practitioners' (GPs') referrals to secondary care would facilitate equitable distribution of workload and allow planning to meet access time targets. This study assessed GP's referral patterns across a metropolitan health authority, which has actively encouraged generic referrals.
A focus group of GPs was used to determine the factors influencing their referral patterns to secondary care for a surgical opinion. A questionnaire was devised based on the factors that emerged from the focus group. All GPs attending continuing-medical-education sessions across Doncaster Health authority were asked to complete this questionnaire.
Of the 79 GPs surveyed, 78 completed the questionnaire. Of them, 22% stated that they made generic referrals rather than to an individual surgeon. Almost four of five GPs made referrals specifically to a named surgeon. A total of 43% of the GPs who referred to a named surgeon ranked perceived clinical skills/ competence as the most important factor. The other factors that influenced their decision in order of importance were waiting times (19%), personal rapport with consultant (12.6%) and feedback from patients (12.6%).
Despite encouragement by secondary care and the local health authority, 78% of GPs in the Doncaster area do not make generic referrals. This has to be taken into account in planning service delivery.
全科医生向二级医疗转诊采用通用方式有助于公平分配工作量,并能依据计划实现就诊时间目标。本研究评估了一个积极鼓励通用转诊的大都市卫生当局辖区内全科医生的转诊模式。
采用全科医生焦点小组来确定影响他们向二级医疗寻求外科意见转诊模式的因素。基于焦点小组中出现的因素设计了一份问卷。要求唐卡斯特卫生当局所有参加继续医学教育课程的全科医生填写这份问卷。
在接受调查的79名全科医生中,78人完成了问卷。其中,22%表示他们进行通用转诊而非转诊给特定的外科医生。几乎五分之四的全科医生会专门转诊给指定的外科医生。在转诊给指定外科医生的全科医生中,共有43%将感知到的临床技能/能力列为最重要因素。按重要性排序,影响他们决策的其他因素依次为等待时间(19%)、与顾问的个人关系(12.6%)和患者反馈(12.6%)。
尽管二级医疗和当地卫生当局给予了鼓励,但唐卡斯特地区78%的全科医生并未进行通用转诊。在规划服务提供时必须考虑到这一点。