Evaluation of patient-related administrative burden regarding non-emergency control referrals for family physicians in Slovenia
DOI:
https://doi.org/10.6016/ZdravVestn.3043Keywords:
family practice, workload, time management, administrative efficiency, financial managementAbstract
Background: Non-emergency control referrals are often ordered by a clinical specialist. A control referral demands that a family physician carries out an administrative task to further extend the validity period after its validity period has expired. With the administrative burden on family physicians increasing in today’s healthcare system, the additional “gate-keeper” role of family physicians in repeated issuing of non-emergency control referrals seems redundant. The aim of this study was to evaluate administrative burden regarding the time consumed and money billed for prescribing non-emergency control referrals, and to present a more efficient model for prescribing non-emergency control referrals.
Methods: We designed a cross-sectional quantitative study. By means of automatic statistical data collection with IRIS software, we gathered statistical information regarding control referrals and overall completed tasks in nine selected family physicians’ offices in the “Center” unit of the Ljubljana Community Health Centre, in the time period from 1 March 2018 until 30 June 2018.
Results: Altogether, 7340 referrals were analyzed. Control referrals accounted for 37% (2720 referrals) of all referrals or 75 referrals monthly per GP’s office. The majority of these (90% or 2453 referrals) were for a non-emergency case. As many as 86% (2104 referrals) of non-emergency control referrals were prescribed without a physical examination. A family physician spent on average 68 minutes per week or 3.5% of his or her work time issuing such non-urgent referrals. This time is equivalent to a measured time of ten average visits to the family physician’s office. For issuing non-emergency control referrals, a family physician’s office bills on average €255€ monthly or 6% of all billed services. This accounts to €203,191 monthly for all family physicians in Slovenia and a monthly time load of 2.8% working time.
Conclusion: The administrative burden of issuing non-urgent control referrals is both time- and money-consuming while being apparently unnecessary. We present a new model for issuing control referrals that eliminates unnecessary administrative burden and enables a more systematic pathway for referrals in cases of acute chronic disease exacerbation.
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