Outcomes of referrals from general practice

Scand J Prim Health Care. 1995 Dec;13(4):287-93. doi: 10.3109/02813439508996777.


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Continuity of Patient Care
  • Family Practice / statistics & numerical data*
  • Female
  • Finland
  • Hospital Departments / statistics & numerical data*
  • Hospital Records
  • Humans
  • Infant
  • Male
  • Medical Audit
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Patient Discharge
  • Practice Patterns, Physicians' / statistics & numerical data
  • Referral and Consultation / statistics & numerical data*
  • Utilization Review