地域診療所における患者紹介の分析

To clarify the health needs in a community, three hundred and ten referrals from a public clinic in a typical Japanese rural area were reviewed concerning age, sex, medical facility to which the patient was referred, reason for referral, and disease from January 1, 1986 to December 31, 1990. The referral patients were classified into 4 groups by age ; 0-19, 20-49, 50-69, 70 years old and older. The number of referrals, admissions, operations, and emergency referrals were divided by the number of consultations to obtain the referral, admission, operation, and emergency referral rates, respectively. Haysshi's third method of quantifica-tion was used to analyze the characteristics of the referrals. The referral rates did not differ among the age groups except for the referral rate of men under 20. However, the admission rate increased with age. The operation rate at the age of 50 and older was higher than that of referrals under 50. The emergency referral rate at the age of 70 and older was higher than that of referrals under 70. All rates of adult men were higher than those of adult woman. Analysis by Hayashi's third method of quantification revealed that 4 major characteristics of referrals were "admission factor", "referral facility factor", "disease factor", and "referral reason factor". In conclusion, it is informative and useful for the primary care physician to analyze referral patients to determine the health needs in the community and the kind of primary care services that should be provided.