Outcomes of referrals from general practice.

OBJECTIVE

To investigate hospital referrals by general practitioners, subsequent hospital events, and discharge letters.

DESIGN

Audit of 340 referrals written by 29 general practitioners, hospital case records, discharge letters, and primary care case records.

SETTING

Salo Area Health Authority in southern Finland (population 43,000).

MAIN OUTCOME MEASURES

Referral rates, reasons for referrals, distribution according to specialty, number of hospital days, visits to outpatient-departments, laboratory and radiological examinations, therapeutic procedures, changes in medication and/or diagnosis and availability of discharge letters.

RESULTS

The mean referral rate was 4.5% and varied from 1.6-10.0 per cent. The referring physician's age, sex, and workload did not significantly explain the variation of referral rates between individual general practitioners. A third of all hospital referrals from general practitioners led to a single visit at the hospital outpatient department. Discharge letters were received for 33% of all referrals. A change in medication or diagnosis did not substantially affect the rate of discharge information supplied by the hospital.

CONCLUSIONS

The variation of the referral rates between the individual general practitioners was large. The small number of participating general practitioners (n = 29) did not permit valid explanations for this variation. The referring general practitioner rarely receives discharge letters from secondary care providers.