ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2014
Examining the variation in GPs' referral practice: a cross-sectional study of GPs' reasons for referral.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled 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
- Impact of an interdisciplinary digital consultation platform on general practitioner referrals for musculoskeletal symptoms: a stepped wedge cluster randomized trial.Family practice · 2025Trial
- Cluster randomised trial on the effectiveness of a computerised prompt to refer (back) patients with type 2 diabetes.PloS one · 2018Trial
- Trends in acute specialist contacts following a primary care contact 2012-21-a registry-based study.Scandinavian journal of primary health care · 2026Article
- Defining a theoretical framework for a quality referral at the primary-secondary care interface: a systematic scoping review with qualitative content analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Use of general practitioner services among high-cost older patients in somatic hospitals - a Norwegian registry-based study.BMC health services research · 2026Observational
- Experiences of orthopaedic patients referred from regional hospitals to an intermediate hospital in Namibia: A qualitative study.Curationis · 2026Article
- Perceptions of the usefulness of Choosing Wisely among general practitioners in Norway: a nationwide survey.BMC primary care · 2025Article
- General practitioners experience multi-level barriers to implementing recommended care for hip and knee osteoarthritis: a qualitative study.BMC primary care · 2024Article
- Musculoskeletal disorders in Norway: trends in health care utilization and patient pathways: a nationwide register study.Scandinavian journal of primary health care · 2024Article
- Areas of consensus on unwarranted and warranted transfers between nursing homes and emergency care facilities in Norway: a Delphi study.BMC health services research · 2024Article
- The use of low-value imaging: the role of referral practice and access to imaging services in a representative area of Norway.Insights into imaging · 2023Article
- Gender and age concordance between patient and GP: an observational study on associations with referral behaviour.BJGP open · 2022Article
- Use of Cervical Cancer Screening among Patients of Primary Healthcare Services: Northeast Portugal.Portuguese journal of public health · 2022Article
- Penicillin allergy SHACK: Survey of hospital and community knowledge.Journal of paediatrics and child health · 2022Article
- 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
- Acute Diverticulitis in Young Patients: A Review of the Changing Epidemiology and Etiology.Digestive diseases and sciences · 2022Review
- Health anxiety is an important driver of healthcare use.BMC health services research · 2022Article
- A cross-sectional study of knowledge and practices in the management of patients with Parkinson's disease amongst public practice-based general practitioners and geriatricians.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a large variation in referral rates to secondary care among GPs, which is partly unexplained.
aimTo explore associations between reasons for referral to secondary care and patient, GP, and healthcare characteristics. DESIGN AND
settingA cross-sectional study in Northern Norway.
methodData were derived from 44 (42%) of 104 randomly selected GPs between 2008 and 2010. GPs scored the relevance of nine predefined reasons for 595 referrals from 4350 consecutive consultations on a four-level categorical scale. Associations were examined by multivariable ordered and multivariable multilevel logistic regression analyses.
resultsMedical necessity was assessed as a relevant reason in 93% of the referrals, 43.7% by patient preference, 27.5% to avoid overlooking anything, and 14.6% to reassure the patient. The higher the referral rates, the more frequently the GPs referred to avoid overlooking anything. Female GPs referred to reassure the patient and due to perceived deficient medical knowledge significantly more often than male GPs. However, perceived easy accessibility of specialists was significantly less frequently given as a reason for referral by female GPs compared with male GPs. When the GPs scored the referrals to be of lesser medical necessity, male GPs referred significantly more frequently than female GPs to reassure the patient due to patient preference and perceived deficient medical knowledge.
conclusionThere are striking differences in reasons for referral between Norwegian male and female GPs and between GPs with high and low referral rates, which reflects difficulties in handling professional uncertainty. Referring to reassure the patients, especially when referrals are less medically necessary, may reflect consideration and acquiescence towards the patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.