Today\u2019s referral is tomorrow\u2019s repeat patient: referrals to and between medical outpatient clinics in a hospital

Mariam Safi,Julija Vaisman,Frans Brandt,Bettina Ravnborg Thude,Robyn Clay-Williams

doi:10.1186/s12913-022-07633-y

Mariam Safi, Julija Vaisman + Show 3 more

Open Access

https://doi.org/10.1186/s12913-022-07633-y

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Abstract

BackgroundUnnecessary referrals in Danish hospitals may be contributing to inefficient use of health services already stretched and under pressure and may lead to delayed treatment for patients. Despite a growing awareness in the literature and in practice of issues related to referrals, there has been relatively little research on referrals between specialists in hospital outpatient clinics and how it can be improved. This study aimed to describe the referral patterns to and within the Medical Department at the University Hospital of Southern Denmark. The Medical Department consists of the following medical specialist outpatient clinics; nephrology, pulmonology, endocrinology, cardiovascular, wound outpatient clinic, and a day hospital.MethodsTwo specialist physicians assessed all referrals to the medical specialist outpatient clinics over one month (from 01 September 2019 to 30 September 2019) using data drawn from the Danish electronic patient record system (Cosmic). Data on referral pattern, and patient age and sex, were statistically analysed to identify and characterise patterns of referral.ResultsFour hundred seventy-one (100%) referrals were included in the study. 49.5% (233) of the referrals were from the hospital and 50.5% (238) from general practitioners (GPs). Of the 233 referrals from the hospitals, 31% (72) were from the Medical Department.ConclusionThe high rate of referrals (31%) from own Medical Department or outpatient clinics may reflect an inefficient internal referral process within the department. Improved collaboration between specialists could have the potential to improve health outcomes, timely access to care and more appropriate healthcare resource utilisation.

Highlights

Inter-departmental referrals accounted for 70% (51) and inter-speciality referrals accounted for 30% [21], meaning that some of the outpatient clinics in the Medical Department referred patients to themselves e.g. pulmonology outpatient clinic referring the patient to their own clinic
Day hospital and pulmonology outpatient clinics received the majority of the referrals from internal sources, whereas cardiovascular and pulmonology outpatient clinics received the majority of the referrals from external referral sources
The study revealed that referral practices at the Medical Department at the University Hospital of Southern Denmark are potentially inefficient

Summary

Introduction

The GP will refer the patient to specialist hospital services. The specialist can refer patients to other specialists for Previous studies show that both patients and healthcare professionals find care to be “single-disease” oriented, resulting in gaps in continuity of care for referrals among multiple specialised hospital outpatient clinics (see Fig. 1) [2,3,4,5]. Ensure efficient patient flow and use of resources. Both referral rate and process have significant implications for patients, the healthcare system, and healthcare costs [9]. Unnecessary referrals in Danish hospitals may be contributing to inefficient use of health services already stretched and under pressure and may lead to delayed treatment for patients.

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Conclusion