Of 1,083 encounters at an out-of-hours primary care center in Norway, 14 percent were referred for specialist care hospital admission. The referring physician determined that 21 percent of these referrals could have been avoided if other appropriate healthcare services were available. The most appropriate alternatives for these referrals were as follows, beginning with the most appropriate:
• Next-day appointments at a specialist outpatient clinic
• Admission to a community hospital
• Admission to a nursing home
Respiratory and gastrointestinal problems were the most common potentially avoidable referrals, according to the study.
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