How health system factors influence referral decisions in patients that may have cancer: European symposium report

Harris, Michael; Frey, Peter; Esteva, Magdalena; Gašparović-Babić, Svjetlana; Marzo-Castillejo, Mercè; Petek, Davorina; Petek Ster, Marija; Thulesius, Hans (2016). How health system factors influence referral decisions in patients that may have cancer: European symposium report. Journal of Cancer Research and Therapy, 4(1), pp. 7-10. NobleResearch Publishers 10.14312/2052-4994.2016-2

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Abstract Objective: To identify the system and other non-clinical factors that may influence a General Practitioners’ decision on whether to refer a patient who may have cancer. Study design: Expert group discussion and consensus formation. Methods: A group of eight General Practitioner (GP) researchers from Croatia, England, Slovenia, Spain, Sweden and Switzerland used brainstorming to identify the non-clinical factors that could affect GPs’ decision-making when faced with patients that might have cancer. The group refined and came to a consensus on these factors. Results: Many non-clinical factors are likely to have a significant impact on referral decisions. These include levels of gatekeeping responsibility, funding systems, access to special investigations, fear of litigation, and relationships with specialist colleagues. Conclusions: Many patients with cancer present without red-flag symptoms, but nevertheless still cause a feeling of concern in their GPs. How a health system is organised is likely to influence on how GPs act on those concerns.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Frey, Peter


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




NobleResearch Publishers




Doris Kopp Heim

Date Deposited:

26 Jan 2017 11:21

Last Modified:

11 Sep 2017 07:49

Publisher DOI:





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