Priority Setting and Waiting Time Decision in the Referral Process, How and by Whom?

Priority Setting and Waiting Time Decision in the Referral Process, How and by Whom? A Prospective Cluster Randomized Controlled Trial on the Effects of an Education Program in Priority Setting and Waiting Time Decision in Referrals

The referral letter is used for different purposes: a request for a special diagnostic assessment or medical treatment that the GP cannot perform for the patient, an invitation to have a second opinion about a clinical problem or a wish for mutual responsibility for the medical handling. The individual referral rate between GPs varies greatly, and is an important determinant of secondary care utilization. We wanted to study the various elements and factors having an impact on the referral process, from the moment the GP decides to refer the patient until the hospital consultant assess the referral and prioritise the patient for further investigation or treatment. How and why are we, the GPs who refer, so different? We wanted to

1. identify and describe general practitioners' reflections on and attitudes to the referral process and cooperation with hospital specialists
2. identify and describe hospital consultants' reflections on and attitudes to the referral process and cooperation with general practitioners
3. identify typologies characterising GPs in the referral practice

Design and Methods:

We did two qualitative and one quantitative study. The first was a focus group study with GPs in CPD groups, the second an individual study with hospital consultants, both analyses by using systematic text condensation. The third was a quantitative registration of impressions, facts and feelings in the referral process using a principal component analysis to find typologies for GPs who refer to hospital.

Participants:

GPs referring to Stavanger University Hospital. Hospital consultants at Stavanger University Hospital.

Intervention: No intervention was performed.

Time schedule:

Data Collection finished May 2014.

Inclusion Criteria:

All the 300 GPs referring to Stavanger University Hospital who participate in one of the 58 CPD groups in South Rogaland County and who agree to participate in the study are included.

Exclusion Criteria:

GPs not willing to participate