Please select the eligibility criteria that correspond to the clinical trial below.
Title: Practical Health Co-operation - a Randomised Controlled Intervention Study. The Impact of a Referral Template on Quality of Care and Health Care Co-operation Between Primary and Secondary Care
Brief Summary: The purpose of this study is to examine whether the implementation of a referral template will increase quality of health care delivered and the quality of health care co-operation. The investigators intent to implement a referral template, at the level of the general practitioner (GP), for the referral of patients within 4 separate diagnostic groups:

* dyspepsia/upper GI symptoms
* colonic cancer investigation/lower GI symptoms
* chronic obstructive pulmonary disease (COPD)
* chest pain

Local GP clinics will be randomised to use the referral template or to use standard referral practice. Using a predefined set of quality criteria the investigators will score the process of care in each patient, and compare intervention and control groups. In addition other criteria will be collected and compared between the two groups, e.g.

* time to diagnosis/treatment
* quality of referral
* more appropriate referrals
* patient satisfaction (as measured by a questionnaire)

The investigators hypothesize that the implementation of a referral template will lead to a measurable increase in the quality of health care delivered.


Options:
A: Inclusion Criteria:

* referral to medical department of University Hospital of North Norway, Harstad

Exclusion Criteria:

* children (\< 18 years of age)
* patients with reduced capacity to consent
B: Inclusion Criteria:

* The patient is categorised as asthmatic disease with persistent airway obstruction or COPD in the monitoring system SHL confirmed by the most recent lung function assessment (FEV1/FVC \< 70% after BD and FEV1 ≥ 50% pred after BD) or (FEV1 \< 80% predicted after BD and ≥ 9% reversibility)
* The patient is monitored by the AC service of the SHL.
* The GP of the patient is willing to participate in the trial.
* Written informed consent of participant

Exclusion Criteria:

* Patients treated primary by a pulmonologist
* Patients currently participating in another respiratory intervention study
* When the GP considers it detrimental to the patient to participate in the study
* Serious other non-pulmonary diseases (or disease-stages) that are presumed to lead to "lost to follow-up" because of the severity of the disease course (like diseases with low survival rate or mental deterioration)
* Serious other pulmonary diseases that effect bronchial symptoms and/or lung function, e.g. sarcoidosis, lung cancer, lung fibrosis
* Illiteracy
C: Inclusion Criteria:

* Inclusion criteria were COPD patients hospitalized due to acute exacerbation

Exclusion Criteria:

* Exclusion criteria were the inability to provide informed consent, the presence of psychiatric or cognitive disorders, progressive neurological disorders, organ failure, cancer, or inability to cooperate. Patients who had experienced another exacerbation of COPD in the previous month were also excluded.
D: Inclusion Criteria:

* People who live in either Ringkoebing-Skjern or Ikast-Brande municipalities and have a GP in the municipality and have been in hospital during the last 5 years with a lung related diagnosis or has redeemed a prescription for medication for lung related problems twice during the last year or has had at least two spirometries done during the last year.

Exclusion Criteria:

* People who do not fit the above inclusion criteria

Answer: A