Hospitals rejected 200,000 referrals last year

Hospitals rejected 200,000 referrals last year, or one in seven, DR reports. The organisation Danske Regioner, Danske Patienter, Bedre Psykiatri and the Danish Medical Association agree that the figure is too high and must be reduced.

Patients may be referred to a hospital for specialist examinations after visiting their general practitioner with symptoms such as pain, lumps or mental distress.

Referrals can be rejected because a hospital believes the patient was referred to the wrong department or because the referral lacks information. In some cases, however, the referring doctor is not told where to send the patient instead. The general practitioners’ organisation PLO says this can delay diagnosis and treatment.

According to the Research Unit for General Practice at SDU, the proportion of rejected referrals rose from about 3 per cent to about 15 per cent between 2018 and 2024.

Danske Regioner calls figure unacceptable

Lars Gaardhøj, the Social Democrat deputy chairman of Danske Regioner, said the number was far too high.

“It is absolutely not okay, and it also tells me that we need to get even better at maintaining good dialogue between the general practitioners who make referrals and the hospitals,” he said.

Gaardhøj attributed the increase partly to an increasingly efficient healthcare system that is busier than it was 10 or 20 years ago. He also said the system had become more specialised, making it more difficult for both sides.

“The system, as it probably works today, is a little too rigid, and we need to soften it somewhat,” he said.

Disagreement over the cause

Morten Freil, director of Danske Patienter, an umbrella organisation for patient and carer associations in Denmark, said rejected referrals had serious consequences for patients and that the number must be significantly reduced.

He said the central problem was disagreement over the cause. Hospitals say the quality of referrals is not good enough, while general practitioners believe hospitals lack capacity, he said.

“Whatever the cause, we cannot accept this on behalf of the patients, and the regions must take the lead in solving the problem,” Freil said.

Psychiatry has the highest number of rejections

The problem is particularly serious in psychiatry, according to Jane Alrø Sørensen, secretary-general of Bedre Psykiatri.

“It is simply disgraceful, because we know that getting quick help for mental health problems and illness also means a shorter route back to well-being,” she said.

Sørensen said there could be sound professional reasons for rejecting referrals, but that a considerable proportion of referrals in psychiatry were being sent back.

Bedre Psykiatri wants psychiatric assessment services to become better at accepting referrals and advising where they should be sent, based on their professional expertise, she said.

Josephine Rathenborg, chair of the Danish Medical Association, called the number of rejected referrals “a deeply frustrating and very problematic situation”.

“What we want to ensure is a good and coherent patient pathway in which patients do not fall between two stools,” she said.

Minister says solutions must be found

Health Minister Ida Auken, a Social Democrat, said in a comment that she agreed the large number of rejected referrals was a problem.

“It is crucial to ensure good cooperation on referrals between general practitioners and hospitals, as well as a shared understanding of why a referral was rejected so that this can be avoided in future,” she wrote.

“This work is already well under way, and it is an area I am following closely, because we owe it to patients to find solutions,” Auken wrote.