[Less referrals from general pratitioners to medical specialists: the desired results of a consistent policy].
In a comparison of the 1987 and 2001 Dutch national studies of diagnoses and performance in general practice, a decline was observed in referrals to pediatricians. This decline concerned all pediatric subspecialties, but was particularly marked for acute otitis media and visual impairment. This trend is in line with other observations of general practitioners' interventions in the last two decades. General practitioners treated a larger proportion of health problems presented to them in 2000 (96% of the episodes) than in 1987 (91%). A decline in referrals of all age groups and all specialties was also reported for 1971--1994. The decline in referrals took place in an aging population, while the annual number of contacts between patients and their general practitioners did not change substantially. This reflects the fact that since 1970 health care policy has been directed at a strengthening of general practice. The decline in referrals proves the success of this policy.
van Weel
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Universitair Medisch Centrum St Radboud, Huisartsgeneeskunde, 6500 HB Nijmegen.
D003657:Decision Making; D005194:Family Practice / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008511:Medicine / Q000706:statistics & numerical data*; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013038:Specialization