The process of outpatient referral and care: the experiences and views of patients, their general practitioners, and specialists

Bowling, A and Redfern, J (2000) The process of outpatient referral and care: the experiences and views of patients, their general practitioners, and specialists. British Journal of General Practice (BJGP), 50(451), pp. 116-120. ISSN (print) 0960-1643

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Abstract

Background. The primary care system in the United Kingdom, involving the general practitioner (GP) as gatekeeper to further services, has helped to keep health care costs down. Despite this, unexplained variation in referral rates and increasing health care costs have led to the search for methods of improving efficiency. There is relatively little recent descriptive data on the processes of care at the primary-secondary care interface. The study reported here provides information about this. Aim. To analyse the patterns and process of care for the referral of outpatients, together with the views of patients, their GPs, and specialists. Method. A questionnaire survey of outpatients, their hospital specialists, and GPs in randomly sampled district health authorities in the North Thames Region. The measures included items and scales measuring satisfaction and processes. Results. Almost all of the outpatients thought that their consultation with the specialist was 'necessary' and 'worthwhile'. Most of the GPs felt that they could not have given the study patients the care, treatment, and investigations they received in hospital, and most of the sampled patients' attendances were rated by the specialists as 'appropriate'. However, for just over one-fifth of new patients, the specialists reported that the GP could have done more tests and examinations prior to referring the study patient. Large proportions of GPs in this survey also reported having technical equipment in their practices, as well as direct access to a range of services and hospital-based facilities. Conclusion. A large amount of work is carried out in general practice prior to the hospital referral of patients, and GPs have direct access to some technologies and services that can act to reduce the burden on hospitals. The discrepancy between GPs' and specialists' perceptions about the potential for further investigative work prior to patient referral merits further investigation.

Item Type: Article
Additional Information: This work was supported by the Organisation and Management Group, Research and Development, North Thames Regional Health Authority [grant no P/95/202).
Uncontrolled Keywords: referral, patient satisfaction, general practitioners, hospital specialists
Research Area: Allied health professions and studies
Health services research
Faculty, School or Research Centre: Faculty of Health and Social Care Sciences
Depositing User: Katrina Clifford
Date Deposited: 06 Dec 2010 14:08
Last Modified: 06 Dec 2010 14:08
URI: http://eprints.kingston.ac.uk/id/eprint/17292

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