BACKGROUND The communication of relevant patient information between general practitioners (GPs) and medical specialists is important in order to avoid fragmentation of care thus achieving a higher quality of care and ensuring physicians' and patients' satisfaction. However, this communication is often not carried out properly. The objective of this study is to assess whether communication between GPs and medical specialists in the referral process is associated with the organisation of primary care within a country, the characteristics of the GPs, and the characteristics of the primary care practices themselves. METHODS An analysis of a cross-sectional survey among GPs in 34 countries was conducted. The odds ratios of the features that were expected to relate to higher rates of referral letters sent and communications fed back to GPs were calculated using ordered logistic multilevel models. RESULTS A total of 7183 GPs from 34 countries were surveyed. Variations between countries in referral letters sent and feedback communication received did occur. Little of the variance between countries could be explained. GPs stated that they send more referral letters, and receive more feedback communications from medical specialists, in countries where they act as gatekeepers, and when, in general, they interact more with specialists. GPs reported higher use of referral letters when they had a secretary and/or a nurse in their practice, used health information technologies, and had greater job satisfaction. CONCLUSIONS There are large differences in communication between GPs and medical specialists. These differences can partly be explained by characteristics of the country, the GP and the primary care practice. Further studies should also take the organisation of secondary care into account.

中文翻译：

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转诊过程中全科医生与医学专家之间的交流：在34个国家中进行的横断面调查。

背景技术在全科医生（GP）和医学专家之间的相关患者信息的通信是重要的，以便避免护理分散，从而实现更高的护理质量并确保医师和患者的满意度。但是，这种通信通常不能正确进行。这项研究的目的是评估在转诊过程中，全科医生与医学专家之间的沟通是否与一个国家内的初级保健组织，全科医生的特征以及初级保健实践本身的特征有关。方法对34个国家的全科医生进行了横断面调查。使用有序逻辑多级模型计算了预期与更高的推荐信发送率和反馈给GP的通信率相关的功能的优势比。结果对来自34个国家的7183名GP进行了调查。确实存在国家间发送推荐信和收到反馈信息的差异。国家间的差异很少可以解释。全科医生表示，在他们担任看门人的国家，以及通常与专家进行更多交流时，他们会发送更多的转诊信，并收到更多来自医学专家的反馈信息。全科医生报告说，当他们在实践中有秘书和/或护士，使用了健康信息技术并且对工作满意度更高时，推荐信的使用率更高。结论全科医生与医学专家之间的沟通存在很大差异。这些差异部分可以由国家，全科医生和初级保健实践的特征来解释。进一步的研究还应考虑二级保健的组织。