A list system can help to reduce the proportion of out of hours referrals for male patients

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Abstract
Objective — To examine differences in referral patterns by general practitioners (GPs) with and GPs without a list of patients. Design — Survey of all referrals from primary to secondary care during one week. Setting — Central and northern Finland, in a region comprising 72% of the area of the country and one-third of the population. Participants — 851 GPs, of whom 199 (23%) had a list system. Outcome measures — Referrals in terms of practice characteristics. Results — There were 58 760 consultations during the study period, and 2921 patients were referred to secondary care. GPs with a list referred 64% of all referred male patients and 63% of all referred female patients during normal working hours. The corresponding referral figures for GPs without a list were 43% and 58%. Conclusion — GPs with a list of patients had a more appropriate distribution of referrals between normal and out of hours work than GPs without a list. Our results may help in developing solutions to problems of providing good primary health care.

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