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.