Homeopathic treatment and fibrositis.

identified by reference to the computer held Community Health Index in Ayrshire and Arran Health Board. Questionnaires were then sent to these general practitioners to ascertain the reason for admission in Greater Glasgow Health Board. In all, 222 patients were admitted for 269 operations to 11 hospitals in Greater Glasgow Health Board. Most of the operations (203) were orthopaedic. Sixteen patients died and were not followed up. Replies from general practitioners were obtained for 203 (99%) of 206 patients. In 23 cases (11%) case notes could not be found by the general practitioner. Of the remaining 180 admissions, only 84 (47%) were the result of a referral by a general practitioner in Ayrshire and Arran Health Board. Nearly a third (55 (31%)) of the patients were referred by a hospital consultant, 7% were emergency admissions, 7% were referred by the patient's previous general practitioner in Greater Glasgow Health Board, 6% were patients receiving long term follow up from a Glasgow clinic, and 3% were not known. Of the 84 referred by general practitioners in Ayrshire and Arran Health Board, 40 (48%) were referred because of patient preference. Mapping of the data did not show any geographical pattern, but for 10 out of 40 patients the general practitioner (unprompted) mentioned that the patients wanted a second opinion. For 18 (21%) patients the general practitioner said that facilities were not available locally; for only six (7%) did the general practitioner claim the cross boundary admission was because of a special relationship with the consultant. This small study has shown that the reasons why patients may be admitted to hospitals in another health authority vary greatly, and we need to take great care in making assumptions about the feasibility or costs and benefits of establishing new services.