Referrals to Irish accident and emergency departments.

A prospective survey of samples of thirty consecutive referrals from general practitioners in fifteen European Countries (the European study of Referrals from Primary Care), found that Irish doctors sent a higher proportion (20.6%) of referrals to Accident and Emergency (A&E) Departments than in any other country in the study. Further analysis of the Irish sample showed that 57% of these patients were referred to specialists other than Emergency and Trauma (E&T) (i.e. 12.7% of all referrals). These referrals were mostly for acute medical or surgical conditions requiring inpatient treatment. More non-E&T referrals were sent by doctors closer than 10 km from hospital (26.8% of all their referrals), as compared with doctors 10 km or further from hospital (8.1% of all their referrals). Doctors older than 40 years sent more non-E&T referrals to A&E Departments (16.9% of all their referrals) as compared with those aged 40 years or younger (9.6% of all their referrals). In contrast, referrals to Emergency and Trauma specialists were associated with greater distance to hospital, as doctors closer than 10 km from hospital made only 1.6% of all referrals to the E&T specialty, while doctors 10 km or further from hospital made 12.5% of all referrals to E&T specialists. The author recommends that referrals to non-trauma specialists in the Republic of Ireland should go directly to these specialists, as in all other countries in Europe, thus freeing Emergency and Trauma specialists for their proper Accident and Emergency function.