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Original article

Vol. 145 No. 5152 (2015)

Referral rates in Swiss primary care with a special emphasis on reasons for encounter

  • Ryan Tandjung
  • Andreas Hanhart
  • Fredi Bärtschi
  • Rebecca Keller
  • Andy Steinhauer
  • Thomas Rosemann
  • Oliver Senn
Cite this as:
Swiss Med Wkly. 2015;145:w14244


QUESTIONS UNDER STUDY: Referrals from primary to secondary care reflect a crucial role of primary care physicians (PCPs). Most referral rates are based on the number of consultations, rather than on the number of problems addressed during consultations (reasons for encounter = RFE). The aim of the study was to update data on consultations, RFE and referrals in Swiss primary care and calculate a referral rate based on RFE rather than on the number of consultations.

METHOD: Cross-sectional study in Swiss primary care. PCPs collected data on consultations on 15 different days in three nonconsecutive months in 2012/2013. Demographic data of patients and up to six RFE per consultation were collected. For each RFE the PCP had to indicate whether a referral was initiated. Data were analysed using descriptive statistics.

RESULTS: Ninety PCPs (18.9% females) participated and 24 774 consultations with 42 890 RFE (corresponding to 1.73 [standard deviation 1.07] RFE per consultation) were recorded. A total of 2 427 RFE (of 2 341 consultations) led to a referral, corresponding to a referral rate of 9.44% (95% confidence interval [CI] 9.08–9.81%) based on consultations and 5.65% (95% CI 5.43–5.87%) based on the number of RFE.

CONCLUSIONS: An average of 1.7 RFE per consultation and a broad clinical spectrum of problems were presented in primary care; nevertheless, 94.3% of all problems were solved in primary care, reflecting the crucial role of PCPs as a coordinator of healthcare.


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