BMJ 1994;309:1233 (5 November)

Letters

Appropriateness of referrals to hospital

EDITOR, - In their study of the appropriateness of referrals Glyn Jones Elwyn and Nigel CH Stott used the concept of avoidable referrals.1 They found that 38% of the referrals studied over one year had been avoidable, whereas in a larger study Fertig et al found 15.9% of referrals to have been possibly inappropriate when judged against locally determined guidelines.2 Thirty two of the avoidable referrals in the authors' study were considered to have been due to lack of resources, and it is perverse to judge the decision on referral in these cases as inappropriate. If these cases were included in the appropriate group the proportion of inappropriate or avoidable referrals would fall to 15.5%, almost exactly the same as Fertig et al's finding and well within their 95% confidence interval (11.8% to 20%).2

Since inappropriate referrals do not seem to explain variation in referral rates the authors' approach, which . . . [Full text of this article]


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Relevant Article

Avoidable referrals? Analysis of 170 consecutive referrals to secondary care
G J Elwyn and N C H Stott
BMJ 1994 309: 576-578. [Abstract] [Full Text]

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