Causes and consequences of rejected or returned referrals from general practice

Area of Science:

• Healthcare Management
• Primary Care
• Secondary Care

Background:

• Increasing rates of hospital referral returns to general practitioners (GPs) in various countries.
• Need to understand causes and consequences of referral returns from GP liaison perspectives.

Purpose of the Study:

• To investigate the reasons behind and impacts of referral returns from hospital to general practice.
• To explore the experiences of GP liaison officers regarding referral returns.

Main Methods:

• Individual interviews conducted with 20 GP liaison officers in Southern Denmark.
• Systematic text condensation used for qualitative data analysis.

Main Results:

• Referral returns are viewed constructively when well-argued, offering advice to enhance GP capabilities.
• Poorly motivated returns erode trust between GPs, hospitals, and patients.
• Complex patients (unclear diagnosis, multimorbidity, social issues) face more returns, risking delayed care and health inequalities.
• Referral returns often transfer tasks to general practice.

Conclusions:

• Enhanced dialogue between primary and secondary care can improve patient care.
• Referral returns present risks, particularly for vulnerable patients, and may strain GP-hospital collaboration.
• The drivers and outcomes of referral returns are multifaceted.