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Referral rates in Swiss primary care with a special emphasis on reasons for encounter


Tandjung, R; Hanhart, A; Bärtschi, F; Keller, R; Steinhauer, A; Rosemann, T; Senn, O (2016). Referral rates in Swiss primary care with a special emphasis on reasons for encounter. Swiss Medical Weekly:Epub ahead of print.

Abstract

Questions under study: Referrals from primary to secondary care reflect a crucial role of primary care physicians (PCPs). Most referral rates are based on the number of consultations, rather than on the number of problems addressed during consultations (reasons for encounter = RFE). The aim of the study was to update data on consultations, RFE and referrals in Swiss primary care and calculate a referral rate based on RFE rather than on the number of consultations.
Method: Cross-sectional study in Swiss primary care. PCPs collected data on consultations on fifteen different days in three non-consecutive months in 2012/2013. Demographic data of patients and up to six RFE per consultation was collected. For each RFE the PCP had to indicate whether a referral was initiated. Data was analyzed using descriptive statistics.
Results: Ninety PCPs (18.9% females) participated and 24’774 consultations with 42’890 RFE (corresponding to 1.73 (SD 1.07) RFE per consultation) were recorded. 2427 RFE (of 2341 consultations) led to a referral, corresponding to a referral rate of 9.44% (95%-CI 9.08-9.81%) based on consultations and 5.65% (95%-CI 5.43-5.87%) based on the number of RFE.
Conclusions: An average of 1.7 RFE per consultations and a broad clinical spectrum of problems were presented in primary care; nevertheless 94.3% of all problems were solved in primary care, reflecting the crucial role of PCPs as a coordinator of healthcare.

Abstract

Questions under study: Referrals from primary to secondary care reflect a crucial role of primary care physicians (PCPs). Most referral rates are based on the number of consultations, rather than on the number of problems addressed during consultations (reasons for encounter = RFE). The aim of the study was to update data on consultations, RFE and referrals in Swiss primary care and calculate a referral rate based on RFE rather than on the number of consultations.
Method: Cross-sectional study in Swiss primary care. PCPs collected data on consultations on fifteen different days in three non-consecutive months in 2012/2013. Demographic data of patients and up to six RFE per consultation was collected. For each RFE the PCP had to indicate whether a referral was initiated. Data was analyzed using descriptive statistics.
Results: Ninety PCPs (18.9% females) participated and 24’774 consultations with 42’890 RFE (corresponding to 1.73 (SD 1.07) RFE per consultation) were recorded. 2427 RFE (of 2341 consultations) led to a referral, corresponding to a referral rate of 9.44% (95%-CI 9.08-9.81%) based on consultations and 5.65% (95%-CI 5.43-5.87%) based on the number of RFE.
Conclusions: An average of 1.7 RFE per consultations and a broad clinical spectrum of problems were presented in primary care; nevertheless 94.3% of all problems were solved in primary care, reflecting the crucial role of PCPs as a coordinator of healthcare.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of General Practice
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2016
Deposited On:28 Dec 2015 12:23
Last Modified:05 Apr 2016 19:47
Publisher:EMH Swiss Medical Publishers
ISSN:0036-7672
Free access at:Publisher DOI. An embargo period may apply.

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