ArticleBMC health services research2025
Factors affecting general practitioners' referrals of patients to hip and knee arthroplasty: a focus group study from Northern Norway.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Patients' choice of healthcare provider for primary hip and knee arthroplasty: a national register-based observational cohort study of 62,676 patients from Norway, 2014-2018.Acta orthopaedica · 2026Observational
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Norway, patients have the right to choose their healthcare provider for elective specialized treatments, including the approximately 20,000 annual hip and knee arthroplasty surgeries. There is considerable regional variation in mobility - 'patient leakage' - out of a regional health authority for patients seeking these surgical procedures. General practitioners play a vital role in this decision-making process, acting as gatekeepers in referring patients to specialized healthcare. This study investigates the factors influencing Norwegian general practitioners' referral decision for hip and knee arthroplasty surgeries.
methodsWe conducted five focus group interviews with 28 general practitioners across various municipalities in Northern Norway, selected based on differing levels of 'patient leakage' according to the Norwegian Patient Registry. The thematic analysis focused on: 1. The involvement of general practitioners, patients, and other parties in the decision-making process, and 2. The impact of interpersonal, service-related, and broader societal factors on these decisions.
resultsThe analysis identified four main themes: 1. Navigating referral decisions, 2. Patients' expectations, knowledge, and beliefs, 3. Service factors affecting referral practices, which includes sub-themes such as hospital reputation, general practitioners' familiarity with specialists, selection bias, and concerns for post-operative care, and 4. Societal and structural factors, including geographic logistics and local hospital disputes.
conclusionThe decision-making process for selecting treatment providers is complex and influenced by multiple intersecting factors. While general practitioners are crucial in guiding patient referrals, many elements contributing to 'patient leakage' are beyond their control. Our results suggest that policies to address patient leakage should encompass a broader, cross-sectoral approach rather than focusing solely on healthcare services.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.