patients who were assessed to require examination by a consultant Design -Retrospective evaluation of referrals to three hospitals within 1 week only 34% actually saw the specialist within that time. during 1 week.Of those patients who were assessed to be require the treatments Setting -Referrals to internal medicine departments of Kuopio Uniwithin 8 -30 days, 48% were examined by a specialist within that time. versity Hospital, Kajaani central hospital and Pieksämäki regional Conclusion -It is possible to reliably assess the urgency of referrals hospital in Finland.to internal medicine departments. There is a need to improve the Participants -Two specialists in internal medicine working in univerreferral process for those patients requiring consultation with a sity hospital and four specialists in general practice, two of whom hospital specialist within 30 days. were private sector general practitioners (GPs), the other two being Key words: primary health care, referral and consultations, corresponpublic health centre chief physicians.dence, waiting times, Finland. Outcome measures -Postreferral waiting times, assessment of the urgency of the referral by a panel of doctors, and the reliability of this assessment.Arto Veh7iläinen, MD, Department of Community Health and GenResults -Mean delay to specialist consultation was 36 days. There eral Practice, Uni7ersity of Kuopio, P.O. Box 1627, FIN-70211 were no significant differences between the assessors in their opinions Kuopio, Finland.