title: A list system can help to reduce the proportion of out of hours referrals for male patients.
abstract: OBJECTIVE
  To examine differences in referral patterns by general practitioners (GPs) with and GPs without a list of patients.
  
  
  METHODS
  Survey of all referrals from primary to secondary care during one week.
  
  
  METHODS
  Central and northern Finland, in a region comprising 72% of the area of the country and one-third of the population.
  
  
  METHODS
  851 GPs, of whom 199 (23%) had a list system.
  
  
  METHODS
  Referrals in terms of practice characteristics.
  
  
  RESULTS
  There were 58760 consultations during the study period, and 2921 patients were referred to secondary care. GPs with a list referred 64% of all referred male patients and 63% of all referred female patients during normal working hours. The corresponding referral figures for GPs without a list were 43% and 58%.
  
  
  CONCLUSIONS
  GPs with a list of patients had a more appropriate distribution of referrals between normal and out of hours work than GPs without a list. Our results may help in developing solutions to problems of providing good primary health care.
authors.affiliation: University of Kuopio, Department of Community Health and General Practice, Finland.
authors.forename: A T
authors.initials: AT
authors.lastname: Vehviläinen
authors.forename: E A
authors.initials: EA
authors.lastname: Kumpusalo
authors.forename: J K
authors.initials: JK
authors.lastname: Takala
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care; D005194:Family Practice / Q000458:organization & administration; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D012017:Referral and Consultation / Q000458:organization & administration / Q000706:statistics & numerical data; D012737:Sex Factors; D013997:Time Factors