Where there is no surgeon: the effect of specialist proximity on general practitioners' referral rates

Gruen, RL; Knox, SA; Britt, H; Bailie, RS

Where there is no surgeon: the effect of specialist proximity on general practitioners' referral rates

Gruen, RL Knox, SA Britt, H Bailie, RS

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Publisher:: Australian Medical Association
Publication Type:: Journal Article
Citation:: Medical Journal of Australia, 2002, 177 (2), pp. 111 - 115
Issue Date:: 2002-01

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Field	Value	Language
dc.contributor.author	Gruen, RL	en_US
dc.contributor.author	Knox, SA	en_US
dc.contributor.author	Britt, H	en_US
dc.contributor.author	Bailie, RS	en_US
dc.date.issued	2002-01	en_US
dc.identifier.citation	Medical Journal of Australia, 2002, 177 (2), pp. 111 - 115	en_US
dc.identifier.issn	0025-729X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/9668
dc.description.abstract	Objective: To determine the effect of proximity of surgical specialists on general practitioners' (GPs') rates of referral of surgical problems to specialist care (ie, are surgical referral rates of GPs in rural or remote areas similar to those of GPs in urban centres?). Design: A cross-sectional survey of GPpatient encounters. Setting: The Bettering the Evaluation and Care of Health (BEACH) program, which involves all active registered GPs in Australia. Participants: A random sample of 3030 GPs, each providing details of 100 consecutive patient encounters. Main outcome measures: Proportion of surgical problems (including ophthalmological and obstetric and gynaecological) referred to surgical specialists (surgeons' rooms, hospital outpatient departments or hospital emergency departments). Results: Absence of a local specialist did not significantly influence the proportion of surgical problems referred by GPs overall, but the proportion referred was significantly lower for obstetric (odds ratio [OR], 0.56; 95% CI, 0.440.70) and ophthalmological (OR, 0.60; 95% CI, 0.490.73) problems. Other factors independently associated with referral of a lower proportion of problems included male GPs, female and younger patients, holders of a Health Care Card, injury-related and non-cancer-related problems, follow-up presentations, and more than one problem managed at an encounter. Conclusions: Our findings confirm that rural and remote GPs undertake much of their patients' antenatal care, and are less likely to use specialists when managing ophthalmological problems. Absence of local specialists in other surgical specialties is not a barrier to referral of patients with surgical disorders.	en_US
dc.publisher	Australian Medical Association	en_US
dc.relation.ispartof	Medical Journal of Australia	en_US
dc.subject.classification	General & Internal Medicine	en_US
dc.title	Where there is no surgeon: the effect of specialist proximity on general practitioners' referral rates	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	177	en_US
utslib.for	140208 Health Economics	en_US
utslib.for	111799 Public Health and Health Services not elsewhere classified	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1701 Psychology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
utslib.copyright.status	open_access
pubs.consider-herdc	false	en_US
pubs.issue	2	en_US
pubs.volume	177	en_US

Abstract:

Objective: To determine the effect of proximity of surgical specialists on general practitioners' (GPs') rates of referral of surgical problems to specialist care (ie, are surgical referral rates of GPs in rural or remote areas similar to those of GPs in urban centres?). Design: A cross-sectional survey of GPpatient encounters. Setting: The Bettering the Evaluation and Care of Health (BEACH) program, which involves all active registered GPs in Australia. Participants: A random sample of 3030 GPs, each providing details of 100 consecutive patient encounters. Main outcome measures: Proportion of surgical problems (including ophthalmological and obstetric and gynaecological) referred to surgical specialists (surgeons' rooms, hospital outpatient departments or hospital emergency departments). Results: Absence of a local specialist did not significantly influence the proportion of surgical problems referred by GPs overall, but the proportion referred was significantly lower for obstetric (odds ratio [OR], 0.56; 95% CI, 0.440.70) and ophthalmological (OR, 0.60; 95% CI, 0.490.73) problems. Other factors independently associated with referral of a lower proportion of problems included male GPs, female and younger patients, holders of a Health Care Card, injury-related and non-cancer-related problems, follow-up presentations, and more than one problem managed at an encounter. Conclusions: Our findings confirm that rural and remote GPs undertake much of their patients' antenatal care, and are less likely to use specialists when managing ophthalmological problems. Absence of local specialists in other surgical specialties is not a barrier to referral of patients with surgical disorders.

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http://hdl.handle.net/10453/9668