New Zealand general practitioners' non-urgent referrals to surgeons: who and why?
OBJECTIVE
To describe the clinical and demographic characteristics of patients referred by general practitioners (GPs) to both public and private sectors for non-urgent surgical assessment.


METHODS
During 2004, a cohort of 1420 adult patients with the potential to benefit from elective surgery was recruited into the study by their GPs. GPs recorded patient demographics and reasons for referral.


RESULTS
345 out of 828 eligible GPs (42%) agreed to participate in the study and submitted data on 1603 referrals, 2.4 referrals per reporting week. After excluding ACC cases, data on 1420 referrals were analysed. Forty-two percent of those referred were male and 69% were European New Zealanders. The mean age was 55 years. The largest number of referrals were made to general surgery (37%), followed by orthopaedics (19%), gynaecology (12%), and plastic surgery (10%). The modal level of urgency was "routine" and in 24% of cases cancer was a possibility. The GP felt surgery was needed in 47% of cases, while in 73%, assistance with diagnosis and management was sought. In only 3% of eligible cases was no referral made.


CONCLUSIONS
Elective surgical referral makes up a significant proportion of GP workload. In more than half of cases advice on diagnosis or management, rather than surgery, was sought, and in nearly two-thirds the patient was aged less than 65 years. Cancer control was a relatively frequent goal of referral. The very small number of cases where a desired referral was not made suggests that GP and patient expectations are adjusted to service capacity.
Health Services Research Centre, Victoria University of Wellington, PO Box 600, Wellington, New Zealand. antony.raymont@vuw.ac.nz
Antony
A
Raymont
Sonya
S
Morgan
Deborah
D
McLeod
Anthony
A
Dowell
Andre
A
van Rij
Jackie
J
Cumming
Megan
M
Pledger
Kevin
K
Dew
Donna
D
Cormack
D000328:Adult; D000368:Aged; D017558:Elective Surgical Procedures / Q000145:classification*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006292:Health Priorities; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D009520:New Zealand; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013038:Specialization; D014850:Waiting Lists