A statewide university hospital-based family medicine referral service

A statewide university hospital-based family medicine referral service was established at the University of Oklahoma in July 1983. During the first six months of operation, 14 percent of all patients admitted to the family medicine inpatient service were referred by outside physicians. Referral patients had more diagnoses coded per admission (2.25) than continuity patients (1.56) (P less than .05). In referral patients, 23.3 percent of diagnoses fell into the 52 most common diagnostic cluster described by Rosenblatt et al compared with 50.9 percent in continuity patients (P less than .0005). Specialty consultations, invasive diagnostic procedures, surgical procedures, and average length of hospital stay were compared in the subgroup of patients with medical, pediatric, surgical, and gynecological principal diagnoses. Referred patients averaged 0.974 consultations per admission compared with 0.578 in continuity patients (P less than .01). An average of 1.237 invasive diagnostic procedures per admission were performed in referral patients compared with 0.626 in continuity patients (P less than .0005). Referral patients averaged 0.145 surgical procedures per admission compared with 0.123 in continuity patients (not significant). The average length of stay for both continuity and referral patients was 9.68 days per admission. A survey of the referring physicians indicated that both the physicians and the patients whom they referred were generally satisfied with the care provided by the service.