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Inappropriate out-patient referrals increasing?

¹University of Leeds.

The British Journal of Clinical Practice

|March 1, 1993

Summary

This study found no increase in inappropriate general practitioner referrals to otolaryngology services between 1981 and 1989. The proportion of unnecessary outpatient referrals remained stable over the study period.

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Area of Science:

Otolaryngology
Health Services Research
General Practice

Background:

General practitioner (GP) referrals form a significant part of otolaryngology caseloads.
Assessing the appropriateness of these referrals is crucial for efficient healthcare resource allocation.
Previous studies suggested a potential rise in inappropriate referrals, necessitating updated analysis.

Purpose of the Study:

To investigate whether the rate of inappropriate general practitioner out-patient referrals to an otolaryngology unit has changed over time.
To compare referral patterns and appropriateness between two distinct time periods.

Main Methods:

A retrospective analysis of new out-patient attendances at an otolaryngology unit in North-East England.
Comparison of patient demographics, diagnoses, waiting times, and consultation outcomes for new attenders in 1981 and 1989.
Definition of inappropriate referrals as new attenders without evidence of otolaryngological disease requiring no further intervention.

Main Results:

A total of 2200 new attendances were analyzed (819 in 1981, 1381 in 1989).
Inappropriate referrals constituted 15% (95% CI, 12-18%) in 1981 and 13% (95% CI, 11-15%) in 1989.
No statistically significant increase in the proportion of inappropriate referrals was observed between the two years.

Conclusions:

The proportion of inappropriate general practitioner referrals to this otolaryngology service remained stable between 1981 and 1989.
This suggests consistent referral practices or effective gatekeeping by general practitioners over the observed period.
Further research could explore factors influencing referral appropriateness in different specialties and regions.

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