Quality in primary care
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Quality in primary care · Jan 2011
Reducing variation in general practitioner referral rates through clinical engagement and peer review of referrals: a service improvement project.
General practitioner (GP) referral rates to hospital services vary widely, without clearly identified explanatory factors, introducing important quality and patient safety issues. Referrals are rising everywhere year on year; some of these may be more appropriately redirected to lower technology services. ⋯ This intervention appeared acceptable to GPs because of its emphasis on reviewing appropriateness and quality of referrals and was effective and sustainable while the investment in resources continued. Consultant involvement in discussions appeared important. The intervention's cost-effectiveness requires evaluation for consideration of future referral management strategies.
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All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would benefit from the contribution of health services research (HSR) on a wide range of topics. As funding for such research is limited, priorities need to be defined. ⋯ Given funding constraints, it is imperative that research priorities are identified to ensure that resources are devoted to the most pressing and important issues facing primary care. Priority areas for future research are amongst others the evaluation of primary care reforms in Europe, and the relations between primary and secondary care.