Objective: To study the number and quality of the referrals from primary care to pneumology. To analyse their relationship to specialist medical training and the attendance pattern.
Design: A descriptive, retrospective study.
Setting: A Pneumology Clinic at the Peripheral Specialities Centre at Cartuja (Granada).
Patients and other participants: 597 referrals were gathered. These were for all the patients referred from primary care to this clinic from may to december 1992.
Measurements and main results: The overall population referral rate per 100,000 inhabitants and month of study was 39.73. The out-clinic doctors referred twice as many patients as health centre (HC) doctors, with OR = 2.01 (1.70 < OR < 2.36). Taken together, general physicians referred three times more than family doctors, with OR = 3.04 (2.54 < OR < 3.78). Regarding the quality of the referral documents, HC doctors accompanied a referral with sufficient information eleven times more often than out-clinic doctors, with OR = 11.38 (6.13 < OR < 21.47). Family doctors contributed this "correct" information thirteen times more often than general physicians without specialist training: OR = 13.50 (8.06 < OR < 22.67).
Conclusions: The number and quality of referrals appear to be closely related to the attendance pattern and in particular to the specialist training of health professionals.