Does the doctors' professional experience reduce referral rates? Evidence from the Finnish referral study.
OBJECTIVE
To examine hospital referral rates in Finnish health centres according to doctors' and health centres characteristics.


METHODS
Survey of all general practice hospital referrals over one week.


METHODS
Central and northern part of Finland, in a region comprising 72% of the area of the country and one-third of the population.


METHODS
851 health centre doctors.


METHODS
Referral rates in terms of characteristics of doctors and health centres.


RESULTS
During the study period, the 851 health centre doctors had 58 760 consultations (mean 69 patients/week), and 2 921 (5%) patients were referred to secondary care. The variation between the highest and lowest referral quintile of the doctors was almost 17-fold, and of the health centres 2.4-fold. Relatively more referrals were made by locums, young, not yet graduated and female doctors than by specialized, more experienced and male doctors.


CONCLUSIONS
A low referral rate is closely connetected with the extent of the general practitioners' professional experience and specialist training. Investing in specialist training and continuing medical education seems to be the best way to reduce high referral rates.
Vehviläinen
A T
AT
University of Kuopio, Department of Community Health and General Practice, Finland
Kumpusalo
E A
EA
Voutilainen
S O
SO
Takala
J K
JK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013038:Specialization / Q000706:statistics & numerical data