Outpatient services and primary care: scoping review, substudies and international comparisons. Health Serv Deliv Res 2016;4(15)
This study updates a 2006 literature review on ways of improving the effectiveness and efficiency of hospital outpatient services. A review of the current literature found that substantial areas of care traditionally given in hospitals can be transferred to primary care. For example, relocating specialists to work in the community is popular with patients, and joint working between specialists and general practitioners (GPs) can be of substantial educational value. A series of substudies investigated five areas: referral management centres, in-house review of referrals by GPs, financial incentives to reduce referrals, consultants contracted to community organisations and, last, international experiences of moving care from hospital into the community. They conclude that high-quality care in the community can be provided for many conditions and is popular with patients, but may not always be cheaper.
Added to the Acute Care in the community page of the Handbook.