[Patterns of referring patients by general practitioners to specialist consultation--an international comparison]

The prospective study of referrals from 46 general practices in the Republic of Croatia to specialist consultation was carried out in the course of 1989 and 1990. A total of 39 specialists in GP, 3 trainees and 4 general practitioners were involved. Each GP marked period required for referral of 30 patients. The data collected included 1375 referrals and 22740 examined patients. The results from our study were compared with the analogous data collected in other 14 countries within the European Study of Referrals from Primary Care. In European countries the observed range of referral rates was almost fourfold (81.7 in Norway, 26.0 in France). The referral rate for the Republic of Croatia is 60.7 ranking Croatia fourth in the European comparison. The re-referral make 55.3% of all referrals in Croatia thus ranking Croatia first in the European comparison. Croatian GPs consult the following specialists (in order of importance): ophthalmologist (11.9%), surgeon (10.8%), internist (7.8%), otolaryngologist (7.6%), cardiologist (6.7%) and orthopedist (6.0%). A considerable variability of individual referral rates was noticed in the studied group of Croatian GPs (from 23.4 to 461.5). The value of determination coefficient R2 = 0.3233 was obtained using the classical multiple linear regression based on the system of predictors, which included 12 referral characteristics. This explained 32% of referral variability of the studied group. The ratio of routine referred patients (having the largest ratio of re-referrals), and the median age of referred patients had the most significant contribution to the coefficient of determination.(ABSTRACT TRUNCATED AT 250 WORDS)