Original scientific paper
SIGNIFICANCE OF REFERRING PATIENTS TO PSYCHIATRISTS FROM FAMILY PRACTITIONER’S OFFICE
Jasna Ercegović
Milica Katić
Abstract
In the Croatian health care system family physicians/ general practitioners (GPs) are supposed to be its “gate keepers”. They are obliged to refer patients to other health care levels when they assess that the patient’s problem could not be solved on primary care level or if there is a need for the second opinion. Neurotic and affective disorders associated with stress and somatoform disorders are highly
prevalent in GPs’ among mental and behavioral disorders.
The aim of this study was to determine the extent, reasons and justification for referring patients to psychiatric consultation.
In this retrospective, cross-sectional study data were collected from electronic medical records of patients, registered at the GP in Kaštel Sućurac, referred to psychiatrist for any reason in 2011. A questionnaire was designed and data were extracted from the electronic medical records, about the patients (personal identification number, age, sex, education, employment status, place of residence,
marital status, disease duration, disease stage) and about referrals (first or repeated, who indicated the referral, reason for referral, diagnosis, outcome, assessment of the justification, the type and amount of therapy). Data were analyzed by descriptive statistics with the χ2 test to assess the observed differences. Out of the 1665 registered patients in 2011, 121 (7.3%) were referred to psychiatrist 121 (7.3%); 86(71.1%) men and 35 (28.9%) women. There were
altogether 498 referrals, averaging 4.11 per patient. According to the ICD-10, most referrals were coded as F40-F49 (47.49%) and F30-F39 (22.8%). The average duration of those mental and behavioral
disorders was 4.36 years. Most consultations (89.6%) were issued for patients in a compensated state. Repeated referrals were highly prevalent: 467 or 93.8%, mostly instigated by the consultants (343
or 68.9%), as regular control or check-up visits. The GP estimated that only 73 referrals (14.6%) were justified.
The conclusion is that most mental referrals were not professionally justified. The patients were mostly compensated patients referred for control check ups, often for administrative reasons. A change in sociopolitical paradigm, and possibly some additional psychiatric training for GPs are required In order to resolve less severe mental
disorders at the primary care level.
Keywords
general practice; mental and behavioral disorders; referrals to psychiatrist; justification for referrals
Hrčak ID:
136259
URI
Publication date:
13.3.2015.
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