Family Physicians’ Perspective on Specialists’ Reply Letters

DOI: 10.3238/zfa.2020.0369-0375

german translation / full article

Tobias Deselaers, Christoph Heintze, Wolfram Herrmann

Keywords: ambulatory care continuity of patient care health services research postal survey reply letter

BackgroundReferrals and reply letters are an important exchange of information between family physicians (FPs) and specialists. However, the frequency of specialists’ reply letters to referrals from FPs has not yet been investigated in Germany. This study aimed to capture the FPs´ perspective on reply letters by specialists and to estimate the frequency of specialists’ replies.MethodsA random, cross-sectional sample of 2000 FPs in Berlin and Brandenburg were contacted via mail to fill a questionnaire. Participants conveyed their satisfaction and their preferences regarding the communication with fellow specialists. Additionally, FPs estimated the number of referrals sent out and reply letters received in one day as well as the number of reply letters received per speciality. We conducted a descriptive analysis of the data and a regression analysis to identify relevant influencing factors on the frequency of specialists’ reply letters. ResultsAnswers from 444 FPs were analysed (23 % response rate). Less than half of the FPs surveyed were satisfied with the reply letters from specialists. The participants wished an overall better representation of a FPs function and advocated for a gate keeper concept. The mean estimated rate of reply letters per referral was 0.32 (SD = 0.21, median = 0.27). Participants stated that specialists of internal medicine would often send reply letters to referrals, whereas replies by orthopaedists, dermatologists and gynaecologists were less frequent. The regression analysis found that FPs who assessed themselves as having a close collaboration with specialists received reply letters more frequently (OR: 2.02; 95% CI: 1.07–3.88). Furthermore, female FPs were associated with a lower reply letter rate (OR: 0.79; 95% CI: 0.64–0.96).ConclusionsOverall, the FPs surveyed indicated room for improvement in the communication with specialists and estimated a low reply letter rate. The number of specialists’ reply letters varied largely according to the speciality to which the patient was referred. Therefore, interventions to improve interdisciplinary communication should be tailored to specific specialities. Additionally, promoting a closer collaboration between FPs and specialists might lead to a higher number of reply letters.Keywordsreply letter; continuity of patient care; ambulatory care; health services research; postal survey

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(State: 14.09.2020)

Latest Issue 9/2020

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