Researchers have explored factors that influence general practitioners (GPs) when referring patients to municipal prevention and rehabilitation services. The findings are now presented in a report based on 21 qualitative interviews and two focus group interviews with GPs from all five regions of Denmark.

The report shows that GPs often face challenges when referring patients to municipal services. The main barriers are a lack of overview of available services, time constraints and insufficient feedback.

Referral practices vary

The GPs report considerable variation between municipalities in terms of the services offered, how services are organised, and how patients can access them. This makes it difficult for GPs to maintain an overview of available services, even though the referral process itself is technically straightforward.

Some GPs feel that referrals can “disappear into the system”. Feedback and clearer role delineation could strengthen trust in the services and increase GPs’ willingness to make referrals.

“It can be difficult to maintain an overview of local municipal services. As a GP, you may have patients in different municipalities, making it challenging to keep track of all the available services. In addition, GPs are not always informed whether the patients have completed the programme. These are barriers, but they are things we can address,” says Anna Mygind, one of the researchers involved in the report and a senior researcher at the Research Unit for General Practice in Aarhus.

Motivation, resources and structures matter

Patients’ motivation, resources and life circumstances are often considered when GPs assess whether to refer patients to a municipal service. The aim is to tailor the intervention to the individual patient. At the same time, this approach holds a risk that patients with limited resources are less often referred to municipal services, and this may lead to unintended selection.

The investigation shows that GPs’ referral practices depend on local structures, but also their own previous experiences and individual assessments matter. These new insights may help strengthen cross-sectoral collaboration and pave the way for more equitable access to services for patients.

“GPs rarely know what municipal prevention and rehabilitation services involve. They are familiar with the hospital sector because GPs work here as part of their training, whereas the municipal sector is less familiar. This makes the transition to municipal services particularly challenging,” explains Anna Mygind.

Next step: developing models for collaboration

The report is part of a larger project on collaboration between general practice and the municipal prevention and rehabilitation services in Denmark. The researchers are currently exploring municipal staff members’ experiences of the collaboration and are also conducting a qualitative study among patients with chronic conditions to identify areas where collaboration between general practice and municipalities could be improved.

“Together with patients, general practice and municipal prevention and rehabilitation services, we want to develop concrete models for collaboration. That is our next step. With the Danish healthcare reform, it's more important than ever to ensure coherent care pathways for the many patients living with chronic conditions,” Anna Mygind concludes.

Further information

Senior researcher Anna Mygind
Research Unit for General Practice, Aarhus
E-mail: mygind@ph.au.dk