An analysis of referral patterns for XXXX in the primary care setting.

@entity1 @entity16 @entity74 @entity1296 @entity2169
BACKGROUND: The majority of @entity74 are non life-threatening and symptoms will resolve spontaneously. However, some @entity1 require further investigation and many disorders may benefit from specialist treatment it is unclear whether appropriate identification and referral of this group of @entity1 presently occurs. AIM: To review the management of @entity1 with symptoms of @entity1296 within primary care. METHOD: A retrospective review of the management of 503 @entity1 who visited their general practitioner (GP) complaining of @entity1296 between August 1993 and July 1995. Management was then compared with local criteria. RESULTS: On average, 2.2% of @entity1 per year at the practices studied consulted their GP about @entity1296 , amounting to 0.7% of all consultations. The most common GP diagnosis was of an ear, nose, and @entity2169 (33.8%). Similarly, many of the 16% referred were directed to ENT (36%) specialists. The proportion of @entity1 referred was significantly higher in those seeing their GP at least twice, those with symptoms lasting a year or more, or where there were additional symptoms associated with the @entity1296 , indicative of a cardiac, ENT, or @entity16 . Compared with the local criteria, 17% of management decisions were deemed inappropriate. The major failing was not referring appropriate @entity1 . This group comprised @entity1 with chronic, non-urgent symptoms, and were significantly older than those appropriately referred. CONCLUSION: @entity1 with chronic symptoms of @entity1296 , particularly the elderly, are under-referred for specialist consultation and, therefore, do not have access to appropriate treatment regimes. This suggests a need for further training of GPs and evaluation of therapeutic needs of elderly dizzy @entity1 .
