Christensen B, Sørensen H T, Mabeck C E
Institute of General Practice, University of Aarhus, Denmark.
Fam Pract. 1989 Mar;6(1):19-22. doi: 10.1093/fampra/6.1.19.
There are many unexplained differences in the rates at which general practitioners make referrals to other medical specialists. This study investigated 17,586 referrals from 141 general practitioners to specialists in seven specialties in Ringkjøbing county in Denmark. As an expression of the referral rate, a referral index was estimated for every general practitioner. The referral index was the number of referrals to the specialist per 1000 patients per year, including children, standardized for age and sex to the average population in Ringkjøbing county. The following six variables were evaluated in relation to the referral index: specialists in the local area, doctors per practice, consultations per general practitioner per year, patients registered, consultations per 1000 patients per year standardized for age and sex, and supplementary procedures per consultation. Stepwise multiple regression analysis was used. The study showed that the referral index rose both with a better access to specialist and with an increasing number of consultations per practitioner per year. The referral index fell with increased numbers of patients registered. No correlation was found between the referral index and number of supplementary procedures per consultation, number of doctors per practice and number of consultations per 1000 patients per year.
全科医生向其他医学专科医生转诊的比例存在许多无法解释的差异。本研究调查了丹麦灵克宾县141名全科医生向七个专科的专科医生转诊的17586例病例。作为转诊率的一种表达方式，为每位全科医生估算了一个转诊指数。转诊指数是每年每1000名患者（包括儿童）中转诊到专科医生的人数，并根据灵克宾县的平均人口按年龄和性别进行了标准化。针对转诊指数评估了以下六个变量：当地的专科医生、每个诊所的医生数量、每位全科医生每年的会诊次数、登记的患者数量、按年龄和性别标准化的每年每1000名患者的会诊次数以及每次会诊的补充程序数量。采用逐步多元回归分析。研究表明，转诊指数随着获得专科医生服务的便利性提高以及每位医生每年会诊次数的增加而上升。转诊指数随着登记患者数量的增加而下降。未发现转诊指数与每次会诊的补充程序数量、每个诊所的医生数量以及每年每1000名患者的会诊次数之间存在相关性。
