Inappropriate out-patient referrals increasing?

A study was undertaken to determine if inappropriate general practitioner out-patient referrals have increased. Out-patients referred to an otolaryngology unit in north-east England were analysed. Patient, diagnosis, waiting time and outcome of consultation details of new attenders for a two-month period in 1981 and 1989 were compared. New out-patient attenders without evidence of otolaryngological disease, who required no treatment, investigation or follow-up, were defined as inappropriate referrals. A total of 2200 new attendances were studied, 819 in 1981 and 1381 in 1989. In all, 125 referrals (15%; 95% confidence interval, 12-18%) in 1981 and 180 patients (13%; 11-15%) in 1989 were inappropriate. There was no increase in the proportion of inappropriate referrals.