Madeley R J, Evans J R, Muir B
Department of Community Medicine and Epidemiology, University of Nottingham Medical School, Queen's Medical Centre.
J Public Health Med. 1990 Feb;12(1):22-7. doi: 10.1093/oxfordjournals.pubmed.a042501.
As part of the national waiting list initiative, a retrospective survey of routine referrals in seven specialties to Lincoln County Hospital by general practitioners within its catchment area, during the months of January to March 1987 inclusive, was carried out, using data from the hospital's Patient Administration System and the Lincolnshire Family Practitioner Committee. These specialties were identified by managers and clinicians as those in which a significant problem of waiting times and waiting lists existed, both as perceived locally and in comparison with other districts. The total referral rate for all GPs in the study was 9.6 referrals/100 patients on their list/year, which is very close to the average of other studies published elsewhere in the country on this topic. However, the range of referral rates between practices was very wide, varying from 2.8 to 17.6. There were also wide variations within individual practices. It is therefore concluded that, taken overall, 'over-referral' by general practitioners is not the cause of any problem at Lincoln County Hospital. However, the wide variation of referral patterns has been of great interest to the general practitioners themselves. They have requested that referral rates be fed back to them routinely, in the manner of the Prescription Pricing Authority, and this will commence shortly. In addition, a working group of orthopaedic surgeons and general practitioner representatives has met to discuss the implications of the study, and the drawing up of mutually agreed referral protocols, the operation of which would be monitored jointly. The setting up of similar groups in the other specialties is under active consideration.
作为国家候诊名单倡议的一部分，利用林肯郡医院患者管理系统和林肯郡家庭医生委员会的数据，对1987年1月至3月（含）期间其服务范围内的全科医生向林肯郡医院七个专科进行的常规转诊进行了回顾性调查。管理人员和临床医生确定这些专科存在候诊时间和候诊名单方面的重大问题，这在当地是可以察觉到的，并且与其他地区相比也是如此。研究中所有全科医生的总转诊率为9.6次转诊/100名在册患者/年，这与国内其他地方发表的关于该主题的其他研究的平均水平非常接近。然而，各诊所之间的转诊率范围非常广泛，从2.8到17.6不等。在个别诊所内部也存在很大差异。因此得出结论，总体而言，全科医生的“过度转诊”并非林肯郡医院任何问题的原因。然而，转诊模式的广泛差异引起了全科医生自身的极大兴趣。他们要求按照处方定价管理局的方式定期向他们反馈转诊率，这将很快开始。此外，一个由骨科外科医生和全科医生代表组成的工作组已经开会讨论该研究的影响，并起草双方商定的转诊协议，其实施情况将进行联合监测。其他专科也在积极考虑成立类似的小组。
