Improved availability of specialist consultations in primary health care: Impact on physician visits

Abstract

Objective - How do physician visits vary when GPs are given the opportunity to send their patients to private specialists for consultation rather than simply to hospital outpatient clinics. Design - An experimental study. Setting and subjects - In the City of Turku, 3 populations were served over 34 months by different service models. The first model was implemented in municipal health centres by 10 GPs with a list system and an option to consult private specialists. In the second model, there were four GPs in municipal health centres without a list system or the consultation option. In the third model, there were four private GPs with a list system and the consultation option. Outcome measures - Visits to doctors as reported by the population. Results - The populations on a GP's list had more physician visits than those not covered by a list system. Persons not on a health centre GP's list had fewer visits to the private sector and more visits to hospital than those covered by a list system. Conclusion - The possibility for a GP to send a patient for consultation to a private specialist improves the prerequisites for high-quality care without affecting the total number of physician visits.