Comparative analysis of diagnoses by the referring family physician and the hospital admission committee in ambulatory patients at an internal medicine department

The objectives of the present study were, as follows: 1. To what rate do the primary care doctors refer their patients to the regional internal medicine emergency department? 2. What sort of problems are the reasons of the referring? 3. To what extent are the opinions of the referring doctors confirmed or reviewed by the specialists? 4. What rate of the referred patients are admitted or discharged after the urgent consultations and-or interventions. 5. What kind of additional tests were used by the institutional caregivers in order to make accurate diagnoses? 6. What was the fate of the unaccepted patients? Data were collected in the patient document archive of the First Dept. of Medicine of the Albert Szent-Gy?rgyi Medical University, Szeged, Hungary. Each patients' referring notes and inpatient charts between September 15th, 1995 and January 15th, 1996 were studied in a retrospective way. Upon the results of the study, it was concluded, as follows: The primary care doctors referred their patients with right orientation diagnosis to the emergency department in 70% of the cases. 45.8% of the referred pts. were admitted to the internal inpatient ward. The agreement of the referring and discharge diagnoses was greater (85.7%) among the admitted patients as compared to the unaccepted ones (56.8%). 14% of the referred pts. were referred to other specialists by the internists. On the basis of the results the actual messages of the study for an under- and postgraduate medical teaching group, and for the health care politicians are discussed in the paper.