Improved availability of specialist consultations in primary health care: impact on physician visits

Abstract

Objective - r How do physician visits vary when GPs are given the opportunity to send their patients to private specialists for consultation rather than simply to hospital outpatient clinics. Design r - r An experimental study. Setting and subjects r - r In the City of Turku, 3 populations were served over 34 months by different service models. The first model was implemented in municipal health centres by 10 GPs with a list system and an option to consult private specialists. In the second model, there were four GPs in municipal health centres without a list system or the consultation option. In the third model, there were four private GPs with a list system and the consultation option. Outcome measures r - r Visits to doctors as reported by the population. Results r - r The populations on a GP's list had more physician visits than those not covered by a list system. Persons not on a health centre GP's list had fewer visits to the private sector and more visits to hospital than those covered by a list system. Conclusion r - r The possibility for a GP to send a patient for consultation to a private specialist improves the prerequisites for high-quality care without affecting the total number of physician visits.