GP referral to an eating disorder service: why the wide variation?

Background. Early detection and management of patients with eating disorder s is thought to improve prognosis, yet little is known about the factors as sociated with referral of these patients to treatment centres. Aim. To calculate general practitioner (GP) referral rates to a specialist eating disorder service and determine the association between referral rate and general practice and practitioner factors. Method. Referral rate was calculated from a database of routine referrals t o St George's Hospital Eating Disorder Service from January 1990 to May 199 6 and correlated with practice and practitioner details obtained from medic al directories and health authority data. Results. There was a wide variation in referral rates. A higher referral ra te was found to be associated with practice size, proximity to the clinic, female GPs, GPs having the MRCGP qualification, being United Kingdom qualif ied, and offering full contraceptive services. Fundholding was associated w ith lower rates of referral. Conclusion. Patients with eating disorders may be at a disadvantage in cert ain practices. Educational interventions could be targeted towards low refe rrals.