title: Improved availability of specialist consultations in primary health care: impact on physician visits.
abstract: OBJECTIVE
  How do physician visits vary when GPs are given the opportunity to send their patients to private specialists for consultation rather than simply to hospital outpatient clinics.
  
  
  METHODS
  An experimental study.
  
  
  METHODS
  In the City of Turku, 3 populations were served over 34 months by different service models. The first model was implemented in municipal health centres by 10 GPs with a list system and an option to consult private specialists. In the second model, there were four GPs in municipal health centres without a list system or the consultation option. In the third model, there were four private GPs with a list system and the consultation option.
  
  
  METHODS
  Visits to doctors as reported by the population.
  
  
  RESULTS
  The populations on a GP's list had more physician visits than those not covered by a list system. Persons not on a health centre GP's list had fewer visits to the private sector and more visits to hospital than those covered by a list system.
  
  
  CONCLUSIONS
  The possibility for a GP to send a patient for consultation to a private specialist improves the prerequisites for high-quality care without affecting the total number of physician visits.
authors.affiliation: Research Department of the Social Insurance Institution, Helsinki, Finland. aarno.linnala@kela.fi
authors.forename: Aarno
authors.initials: A
authors.lastname: Linnala
authors.forename: Arpo
authors.initials: A
authors.lastname: Aromaa
authors.forename: Kari
authors.initials: K
authors.lastname: Mattila
mesh_terms: D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D005387:Finland; D006302:Health Services Research; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data*; D009819:Office Visits / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013038:Specialization