Læknablaðið - 15.07.1999, Page 28

616
LÆKNABLAÐIÐ 1999; 85
Tilvísanir til sérgreinalækna
Umfang tilvísana heimilislæknis og þörf á sérfræðiþjónustu
H. Þorgils Sigurðsson'-2, Jóhann Ág. Sigurðsson2
Sigurðsson HÞ, Sigurðsson JÁ
Referrals to specialists: evaluation of general
practitioners’ need for assistancc from spccialists
in other fields
Læknablaðið 1999; 85: 616-22
Objective: To examine prospectively the long-term
pattern of referrals of one family practitioner.
Material and methods: Over a period of 8.5 years
(1989-1998), the referral process of one general
practitioner (GP) during his daytime practice in the
Akureyri district (inhabitants around 17,000), Ice-
land, was examined. In this area there were 11 GPs
working at the Community Health Centre, and 40
specialists, most of whom were based at the Commu-
nity Hospital or working as consultants in their pri-
vate practice.
Results: In the 8.5 year period one GP (one of the
authors, HÞS) had 40,634 patient encounters with
8,463 persons (4.7 encounters per person). Of those,
24,952 (61%) were office visits by 7,208 persons
(3.5 visits per person). A total of 1672 patients were
referred to a specialist, of whom 215 were emer-
gency cases. The number of referrals was 41 per
1000 total encounters, and 67 of 1000 office encoun-
ters. There were 1613 (96.5%) completed written
responses from the specialists. Most were referred to
internists (28%), orthopaedists (16%), general surge-
ons (12%), ear, nose and throat specialists (11%),
paediatrists (8%) and gynaecologists (8%). Of those
referred to internists, 43% were referred to gastro-
enterologists and 25% to cardiologists. There were
Frá 'Heilsugæslustöðinni á Akureyri, 2heimilislæknisfræði
Háskóla íslands. Fyrirspurnir, bréfaskipti: H. Þorgils Sig-
urðsson, Heilsugæslustöðinni á Akureyri, IS-600 Akureyri.
Sími: 460 4600, bréfsími; 461 2605; netfang: thorgils@
hak.ak.is
Lykilorð: tilvísanir, heimilislækningar, sérfræðingar.
339 referrals for patients younger than 16 years (54%
boys). Of those, 41% were referred to paediatrists,
26% to an ear, nose and throat specialists, 9% to
orthopaedists and 7% to surgeons.
Conclusions: The use of a written referral works
well in Akureyri. Information on the number and
types of referrals could be useful for determining the
appropriateness for ailocations and future develop-
ment of speciality resources in each area. It could
also serve as a method to help family practitioners
choose areas of their continuous medical education.
Key words: referrats, general practice, specialists.
Ágrip
Tilgangur: Að skoða heildartíðni tilvísana
heilsugæslulæknis yfir langt tímabil og skipt-
ingu þeirra milli sérgreina læknisfræðinnar.
Efniviður og aðferðir: Athugaðar voru allar
tilvísanir í dagvinnu eins heilsugæslulæknis á
Akureyri (HÞS) til sérfræðinga á átta og hálfs
árs tímabili (1989-1998). Á upptökusvæðinu
voru um 17 þúsund íbúar, 11 heimilislæknar á
heilsugæslustöð og um 40 sérgreinalæknar,
sem flestir voru á Fjórðungssjúkrahúsinu á Ak-
ureyri og/eða stunduðu sérfræðistörf á stofum.
Niðurstöður: Á átta og hálfu ári voru alls
skráð 40.634 samskipti HÞS við samtals 8.643
einstaklinga (4,7 heildarsamskipti við einstak-
ling). Viðtöl á stofu voru 24.952 (61%) við
samtals 7.208 einstaklinga (3,5 viðtöl á stofu á
einstakling). Sjúklingum var vísað í 1672 skipti
til sérfræðinga, þar af 215 á bráðamóttöku.
Fjöldi tilvísana var alls 41 á 1000 heildar-
samskipti en 67 tilvísanir af 1000 viðtölum á
stofu voru sendar til sérfræðinga. Alls bárust
1613 (96,5%) skrifleg svör frá sérfræðingum.
Flestum sjúklingum var vísað til lyflækna
(28%), bæklunarskurðlækna (16%), almennra