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[Primary care physicians' referrals to a mental health unit]
M J Gamero Samino1, J Bustos Arenas, M J Cano Lozano
1Centro de Salud Universitario La Paz, Unidad Docente de Medicina Familiar y Comunitaria, Badajoz.
Objective:
To assess the differences between general practitioners (GP) and family and community medicine specialists (FM) in referring patients to the mental health unit (MHU) and the diagnostic agreement between both these groups of doctors and the mental health professionals.
Design:
Observational crossover study.
Setting:
Primary Care. The 5 health centres in the city of Badajoz.
Patients And Other Participants:
The 660 new patients sent to the MHU during 1994.
Measurements And Main Results:
Primary care doctors (GP and FM) referred 660 new patients to the MHU, which amounted to 6.4% of the patients on their lists. GPs referred 6%, as against 6.9% by FMs. Average number of patients referred by each GP to the MHU was 11.76 +/- 8.19; and by each FM, 13.34 +/- 8.37 (no significant differences). Nor were there any differences in the sociodemographic features of the patients referred by the two groups of doctors. 64.6% of the patients sent by GPs were actually seen by the psychiatrist and/or psychologist, against 73% of those referred by the FMs. The diagnostic hypothesis was recorded on 94.6% of the referral forms sent by FMs, against 87.3% of those sent by GPs. There was diagnostic agreement for 73.7% of the patients sent by FMs against 43% of those sent by GPs. The pathology diagnosed in the Mental Health Unit was similar for the patients referred by the two groups of doctors.
Conclusions:
We found no significant differences between GP and FM in referral rates to the MHU in Badajoz, although there is greater diagnostic agreement for the patients referred by FMs.