ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2009
Risk taking in general practice: GP out-of-hours referrals to hospital.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systematic review and narrative synthesis.BMC family practice · 2020Pooled it
- Trends in acute specialist contacts following a primary care contact 2012-21-a registry-based study.Scandinavian journal of primary health care · 2026Article
- Diagnostic equipment and point-of-care tests in Norwegian emergency primary healthcare clinics: a cross-sectional study.Scandinavian journal of primary health care · 2025Article
- The impact of variation in out-of-hours doctors' referral practices: a Norwegian registry-based observational study.Family practice · 2023Observational
- Effects of GP characteristics on unplanned hospital admissions and patient safety. A 9-year follow-up of all Norwegian out-of-hours contacts.Family practice · 2022Article
- Variation in referral rates to emergency departments and inpatient services from a GP out of hours service and the potential impact of alternative staffing models.Emergency medicine journal : EMJ · 2021Article
- What's behind the NEWS? National Early Warning Scores in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- The when and how of the gynaecological examination: a survey among Norwegian general practitioners.Scandinavian journal of primary health care · 2019Article
- Article
- Out of hours care in Germany - High utilization by adult patients with minor ailments?BMC family practice · 2017Article
- NNTs and NNHs: essential for rational prescribing.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Predicting clinical deterioration after initial assessment in out-of-hours primary care: a retrospective service evaluation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Cancer patients' use of primary care out-of-hours services: a cross-sectional study in Norway.Scandinavian journal of primary health care · 2016Article
- Observational
- Chest pain out-of-hours - an interview study of primary care physicians' diagnostic approach, tolerance of risk and attitudes to hospital admission.BMC family practice · 2014Article
- Management of chest pain: a prospective study from Norwegian out-of-hours primary care.BMC family practice · 2014Article
- The numbers needed to inform consent?The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Article
- High referral rates to secondary care by general practitioners in Norway are associated with GPs' gender and specialist qualifications in family medicine, a study of 4350 consultations.BMC health services research · 2013Article
- Defining primary care sensitive conditions: a necessity for effective primary care delivery?Journal of the Royal Society of Medicine · 2012Article
- Insecurity and risk in the consultation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency admissions to hospital at night and weekends are distressing for patients and disruptive for hospitals. Many of these admissions result from referrals from GP out-of-hours (OOH) providers.
aimTo compare rates of referral to hospital for doctors working OOH before and after the new general medical services contract was introduced in Bristol in 2005; to explore the attitudes of GPs to referral to hospital OOH; and to develop an understanding of the factors that influence GPs when they refer patients to hospital. DESIGN OF STUDY: Cross-sectional comparison of admission rates; postal survey.
settingThree OOH providers in south-west England.
methodReferral rates were compared for 234 GPs working OOH, and questionnaires explored their attitudes to risk.
resultsThere was no change in referral rates after the change in contract or in the greater than fourfold variation between those with the lowest and highest referral rates found previously. Female GPs made fewer home visits and had a higher referral rate for patients seen at home. One-hundred and fifty GPs responded to the survey. Logistic regression of three combined survey risk items, sex, and place of visit showed that GPs with low 'tolerance of risk' scores were more likely to be high referrers to hospital (P<0.001).
conclusionGPs' threshold of risk is important for explaining variations in referral to hospital.
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