Creed F, Gowrisunkur J, Russell E, Kincey J
Department of Psychiatry, University of Manchester.
Br J Gen Pract. 1990 Nov;40(340):450-4.
The number of referrals made to a district psychiatry service by each of the local general practitioners over a five year period was counted and a large variation in general practitioner referral rate was found. Ten referral letters from each of the general practitioners were independently assessed for the amount of detail included and a mean score for each general practitioner obtained. A significant negative correlation was found between referral rate and amount of detail in referral letters, that is low referrers wrote very detailed letters. The procedure was repeated over an 18 month period including referrals to the district psychology service. Referral rate to the psychologists was positively correlated with detailed referral letters, that is those who referred many patients to the psychologists wrote detailed letters. This study has indicated a wide variation in the use of the psychiatry and psychology services by general practitioners which cannot be explained solely on the basis of a general referral tendency. It is likely that constructive liaison between psychiatrists and general practitioners, especially those who refer a large number of patients, could enhance the care of patients with psychiatric disorder in general practice.
统计了当地每位全科医生在五年期间转介到地区精神病服务机构的人数，发现全科医生的转介率存在很大差异。对每位全科医生的十封转诊信进行独立评估，统计其中包含的详细信息量，并得出每位全科医生的平均得分。结果发现，转介率与转诊信中的详细信息量之间存在显著的负相关，即转介率低的医生所写的转诊信非常详细。在18个月的时间里重复了这一过程，其中包括转介到地区心理服务机构的情况。转介到心理医生处的比率与详细的转诊信呈正相关，也就是说，那些将许多患者转介给心理医生的人会写详细的信。这项研究表明，全科医生在使用精神病学和心理学服务方面存在很大差异，这不能仅仅基于一般的转介倾向来解释。精神病医生和全科医生之间，尤其是那些转介大量患者的医生之间进行建设性的联络，可能会改善全科医疗中对精神疾病患者的护理。
