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Logo of jroyalcgpracBJGP at RCGPBJGP at PubMed CentralJ R Coll Gen Pract at PubMed CentralRCGP homepage
J R Coll Gen Pract. 1987 August; 37(301): 350–353.
PMCID: PMC1711021

Variation in general practitioners' referral rates to consultants


The variation in the number of patients general practitioners refer to hospital is a source of concern because of the costs generated and the implications for quality and quantity of care This paper compares 32 general practitioners with high referral rates with 35 doctors with low referral rates drawn from a study of 201 doctors. The mean referral rate for all 201 doctors was 6.6 per 100 consultations – for those with high referral rates the mean was 11.8 and for those with low referral rates 2.9. Differences between doctors with high and low referral rates with respect to age, sex, social class and diagnostic case mix of patients consulting were small. Doctors with high referral rates referred more patients in all categories. There were also few differences between the two groups with respect to the characteristics of the doctors themselves or their practices. The findings are discussed in the context of proposals to provide general practitioners with information on their own referral rates compared with those of other doctors.

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Selected References

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  • Starey CJ. A Hospital Outpatient Referral Survey: A Study of the Referral Habits of a Group of General Practitioners. J Coll Gen Pract. 1961 May;4(2):214–222. [PMC free article] [PubMed]
  • Morrell DC, Gage HG, Robinson NA. Referral to hospital by general practitioners. J R Coll Gen Pract. 1971 Feb;21(103):77–85. [PMC free article] [PubMed]
  • Fraser RC, Patterson HR, Peacock E. Referrals to hospitals in an East Midlands city--a medical audit. J R Coll Gen Pract. 1974 May;24(142):304–319. [PMC free article] [PubMed]
  • Cummins RO, Jarman B, White PM. Do general practitioners have different "referral thresholds"? Br Med J (Clin Res Ed) 1981 Mar 28;282(6269):1037–1039. [PMC free article] [PubMed]
  • Wood J. Are the problems of primary care in inner cities fact or fiction? Br Med J (Clin Res Ed) 1983 Apr 2;286(6371):1109–1112. [PMC free article] [PubMed]
  • Wilkin D, Metcalfe DH, Hallam L, Cooke M, Hodgkin PK. Area variations in the process of care in urban general practice. Br Med J (Clin Res Ed) 1984 Jul 28;289(6439):229–232. [PMC free article] [PubMed]

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