Priority referrals to the orthopaedic outpatient clinic--what can we improve?

The aim was to analyse priority referrals from the general practitioner to the specialist in the orthopaedic outpatient clinic. The analysis was conducted during two weeks in 2005. Besides general data and procedures conducted by the orthopaedic surgeons, the adequacy of the priority referral was acquired. 21.9 outpatients were daily examined and they suffered mostly from low-back pain (39%), followed by knee (20%), hip (12%), and shoulder (11%) problems. The priority referral was inadequate in 57% of cases. The X-ray imaging was conducted in 33% of cases, while an intake of oral analgesics was advised in 67% and physical therapy in 73% of the visits. The number of inadequate priority outpatients at the orthopaedic clinic was very high. They could either wait for a scheduled appointment or could be further treated by the general practitioner, as most of the conducted procedures are available at the primary health-care level.