Influence of Royal College of Radiologists' guidelines on referral from general practice. Royal College of Radiologists Working Party.

Abstract

To measure the effect on general practitioner referrals for radiography of introducing guidelines of good practice together with monitoring and peer review. Collection of referral data during 1 January 1989 to 31 December 1990. Guidelines were introduced on 1 January 1990. Open access radiology services provided by one non-teaching district in England. 144614 registered patients from 22 practices. Number of referrals per 1000 registered patients for radiography of the chest, skull, spine, abdomen, limbs, and joints and for barium investigation and excretion urography. Overall referrals fell from 88.4/1000 registered patients to 77.2/1000 after the guidelines were introduced. The commonest reasons for referral were for examination of the chest, spine, and limbs and joints and referrals for these fell by 9.4%, 17.5%, and 13.5% respectively. Referrals for skull radiography fell by 30% (from 241 to 168). By helping general practitioners to be more selective in their use of diagnostic radiology, the guidelines reduced the rate of referral and thus patients' exposure to radiation.