Trial Information

Practical Health Co-operation - a Randomised Controlled Intervention Study. The Impact of a Referral Template on Quality of Care and Health Care Co-operation Between Primary and Secondary Care

There is a continuous work to improve the quality of health care delivered to an individual
patient, both in primary and secondary care. The referral from primary to secondary care
represents a key component in the communication between the levels of care, and therefore an
important tool in developing the quality of care. There has been many attempts at improving
the quality of referrals, but less work has been focussed on the consequence of such
improvement on quality of health care. This study is designed as a randomised controlled
intervention study where we intent to implement a referral templates, at the level of the
general practitioner (GP). These templates will be for the referral of patients within 4
separate diagnostic groups:

- dyspepsia/upper GI symptoms

- colonic cancer investigation/lower GI symptoms

- chronic obstructive pulmonary disease (COPD)

- chest pain

Following the course of the health care process we will assess the quality of the care
process by using predefined quality of care criteria, together with patient satisfaction (as
measured by questionnaire) and other health process indicators.

Our primary hypothesis is that the implementation of a referral template in the
communication between primary and secondary care, will lead to a measurable increase in the
quality of health care delivered.

Secondary hypothesis include:

- the use of a referral template in the communication between the GP and secondary care,
will lead to better patient satisfaction.

- the use of a referral template in the communication between the GP and secondary care,
will lead to a change (up or down) in the amount of patients defined as being in need
of prioritisation (as defined pr. national guidelines for prioritisation in health
care)

- the use of a referral template in the communication between the GP and secondary care,
will lead to a measurable referral quality improvement

- the use of a referral template in the communication between the GP and secondary care,
will increase the "appropriateness" of the referrals