Differences in referral rates to specialised health care from four primary health care models in Klaipeda, Lithuania
2008

Referral Rates in Different Health Care Models in Lithuania

Sample size: 250070 publication 10 minutes Evidence: moderate

Author Information

Author(s): Andrzej Zielinski, Anders Håkansson, Arnoldas Jurgutis, Ingvar Ovhed, Anders Halling

Primary Institution: Lund University, Department of Clinical Sciences in Malmö, General Practice/Family Medicine

Hypothesis

Family medicine practices would provide more comprehensive primary health care services than the polyclinics.

Conclusion

Family medicine practices located in rural areas had significantly lower referral rates to specialised health care compared to urban areas.

Supporting Evidence

  • Patients in rural family medicine practices had lower referral rates than those in urban practices.
  • Co-morbidity levels were correlated with higher referral rates.
  • The study used a large population sample from Klaipeda, Lithuania.

Takeaway

In rural areas, family doctors send fewer patients to specialists than those in cities, which means they might be doing a better job of taking care of their patients.

Methodology

The study analyzed referral rates from 18 primary health care practices using data from the Lithuanian State Sickness Fund database and Poisson regression models.

Potential Biases

Potential bias due to the inability to discern the reasons for increased referral rates in urban areas.

Limitations

The study was limited by the data available from the Lithuanian State Sickness Fund and could not separate referrals from PHC physicians to specialists from those made by specialists to other specialists.

Participant Demographics

The study included 250,070 inhabitants from Klaipeda city and region, with data on age, gender, and co-morbidity levels.

Statistical Information

P-Value

p<0.001

Confidence Interval

1.07–1.53

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1471-2296-9-63

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