Referral and Consultation Practice between Generalists and Specialists at a University Hospital: A Retrospective Cross-Sectional Study
10.14442/generalist.42.92
- VernacularTitle:コンサルテーションからみた大学病院総合診療部の役割―院内他科との診療連携に関する横断研究―
- Author:
Keiichiro KITA
;
Yosuke SHIMIZU
;
Seiji YAMASHIRO
- Keywords:
general physician;
specialist;
referral and consultation practice;
cross-sectional communication
- From:An Official Journal of the Japan Primary Care Association
2019;42(2):92-97
- CountryJapan
- Language:Japanese
-
Abstract:
Background: Few studies have focused on the current state of referral and consultation practice between generalists and specialists at Japanese university hospitals.Methods: We retrospectively analyzed the electronic medical records of 513 outpatients (a cumulative total of 608 patients) who visited the Department of General Medicine of Toyama University Hospital between January and December 2016. All patients used our in-hospital consultation and referral service.Results: We referred 492 new patients to different specialists, with 40% referred to psychiatry, orthopedics, otolaryngology, and dermatology specialists. Our suspected diagnoses were correct for 285 of 395 patients (72%) who were referred to specialists to confirm the diagnosis. No abnormalities were observed in 86 patients (21%), and inappropriate referrals were made for 5 patients (1.2%). We also received 116 consultations from specialists, 66% of which were from orthopedics, psychiatry, gynecology, oral dental surgery, and neurosurgery specialists. Many of the referred patients had vague symptoms such as fever and general fatigue.Conclusion: Improving the practical skills of generalists regarding orthopedic and otolaryngologic problems may result in more appropriate referrals. Our department also served as a consultant for medical problems for specialists, especially orthopedic surgeons and psychiatrists.
