[The GP-arranged referral in outpatient care practice - between coordination, tensions, and improvement of patient care: findings from qualitative focus groups].

BACKGROUND

The GP-arranged referral was introduced in 2019 to accelerate the transfer of medically urgent cases from GPs to specialist care. Following the 2023 reform, the system became more important in terms of health policy and care provision. This study aimed to examine physicians' perceptions of the system, how it was being implemented, its effects on care, interdisciplinary cooperation, and the physician-patient relationship.

METHODS

Eight qualitative focus groups were conducted with 40 physicians from various disciplines. The analysis followed a qualitative content analysis according to Kuckartz.

RESULTS

It was emphasised that patients with a GP-arranged referral obtained appointments more quickly in underserved specialist fields. GPs perceived the additional organisational effort involved as a burden. The regulation changed the dynamic between GPs and specialists, both positively and negatively. Additionally, undesirable effects such as misuse were becoming apparent.

CONCLUSION

While the GP-arranged referral ensures faster and more reliable appointment scheduling, it also reveals structural tensions. To prevent uncertainties and misuse, further development with clearer criteria and unambiguous control mechanisms is required.