Assessment of Referral Patterns and Utilization of Basic Health Facilities in the Outpatient Department of a Tertiary Care Hospital: A Cross Sectional Study

Referral Patterns and Utilization of Basic Health Facilities

Authors

  • Syed Ihtishaam Kakakhel Bacha Khan Medical Complex, Swabi, Pakistan
  • Humaira Mahmood Department of Public Health, Armed Forces Post Graduate Medical Institute, Rawalpindi, Pakistan
  • Jawaria Khan Department of Public Health, Armed Forces Post Graduate Medical Institute, Rawalpindi, Pakistan
  • Gul Makey Mardan Medical Complex, Mardan, Pakistan
  • Muhammad Arif Bacha Khan Medical Complex, Swabi, Pakistan
  • Sadaf Jamil Centre for Disease Control, National Institute of Health, Islamabad, Pakistan
  • Farrukh Habib Department of Public Health, Alhamd Islamic University, Islamabad, Pakistan
  • Sher Afgan Raisani TB control Program Balochistan, Pakistan
  • Dure Yaqta Shaheen National University of Medical Sciences, Rawalpindi, Pakistan
  • Farah Diba Department of Public Health, Armed Forces Post Graduate Medical Institute, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i05.406

Keywords:

Referral, Primary Health Care, Government Facility, Chronic Illnesses

Abstract

The main reason behind poor healthcare delivery is malfunctioning of effective referral system. Objective: To determine the frequency of patients referred through proper channel in medical outpatient department of tertiary health care facility and to determine the causes of not utilizing basic health facilities by employing modified WHO questionnaire on Rapid Assessment of Referral Care System. A Cross-sectional descriptive study conducted in Medical Outpatient Department of Bacha Khan Medical Complex Swabi from 21st April to 21st September. Methods: Up to 400 participants going to medical outpatient department were selected through non-probability convenience sampling. Patient data like socio-demographic variables and questions with respect to referral was documented using a modified version of the Rapid Assessment of Referral Care System questionnaire from the World Health Organization. Percentages and frequencies were computed. Results: Amongst 400 participants who were included in the study, 244(61%) were female participants. About 365(91.3%) participants came to tertiary care hospital while (35) (8.8%) participants were referred. About 79(19.8%) participants were having chronic illness like Diabetes, hypertension, COPD, IHD, Asthma etc. 166(41.5%) participants choose this government facility due to presence of experienced doctors here in this facility. 159(39.8%) participants choose this facility due to presence of better care in this facility. Rest of them 75(18.7%) had other reasons. Conclusions: Most of the patients visited tertiary care hospital directly, with very minor health issues, not utilizing health facilities at the primary and secondary levels of care are overworked, which affects tertiary care facilities.

References

Oyediran KA and Isiugo-Abanihe UC. Perceptions of Nigerian women on domestic violence: Evidence from 2003 Nigeria Demographic and Health Survey. African Journal of Reproductive Health. 2005 Aug: 38-53. doi: 10.2307/3583461.

Panezai S, Ahmad MM, Saqib SE. Factors affecting access to primary health care services in Pakistan: a gender-based analysis. Development in practice. 2017 Aug; 27(6): 813-27. doi:10.1080/09614524.2017.1344188

Shaikh BT and Hatcher J. Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers. Journal of Public Health. 2005 Mar; 27(1): 49-54. doi: 10.1093/pubmed/fdh207.

MEASURE Evaluation. Referral System Assessment and Monitoring Toolkit. 2013. [Last Cited: 17th May 2023]. Available at: https://www.who.int/management/facility/rapidassessmentofreferralcaresystem.pdf

Afsar HA, Qureshi AF, Younus M, Gulb A, Mahmood A. Factors affecting unsuccessful referral by the lady health workers in Karachi, Pakistan. Journal-Pakistan Medical Association. 2003 Nov; 53(11): 521-8.

Abrahim O, Linnander E, Mohammed H, Fetene N, Bradley E. A patient-centered understanding of the referral system in Ethiopian primary health care units. PloS One. 2015 Oct; 10(10): e0139024. doi:10.1371/journal.pone.0139024.

Font F, Quinto L, Masanja H, Nathan R, Ascaso C, Menendez C, et al. Paediatric referrals in rural Tanzania: The Kilombero District Study–a case series. BMC International Health and Human Rights. 2002 Dec; 2: 1-6. doi: 10.1186/1472-698X-2-4.

BASICS II and the Ghana Health Service. The status of referrals in three districts in Ghana: Analysis of referral pathways for children under five. 2003. Available at: https://pdf.usaid.gov/pdf_docs/pnacw616.pdf.

Kiwanuka SN, Ekirapa EK, Peterson S, Okui O, Rahman MH, Peters D, et al. Access to and utilisation of health services for the poor in Uganda: a systematic review of available evidence. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Nov; 102(11): 1067-74. doi: 10.1016/j.trstmh.2008.04.023.

Afsar HA and Younus M. Patient referral at the grass-roots level in Pakistan. Nature and Science. 2004 Jan; 2: 18-27.

Siddiqi S, Kielmann AA, Khan MS, Ali N, Ghaffar A, Sheikh U, et al. The effectiveness of patient referral in Pakistan. Health Policy and Planning. 2001 Jun; 16(2): 193-8. doi:10.1093/heapol/16.2.193.

Haddad S, Fournier P, Machouf N, Yatara F. What does quality mean to lay people? Community perceptions of primary health care services in Guinea. Social Science & Medicine. 1998 Aug; 47(3): 381-94. doi:10.1016/s0277-9536(98)00075-6.

Bakeera SK, Wamala SP, Galea S, Peterson S, Pariyo GW. Community perceptions and factors influencing utilization of health services in Uganda. International Journal for Equity in Health. 2009 Dec; 8(1): 1-2. doi:10.1186/1475-9276-8-25.

Babalola S and Fatusi A. Determinants of use of maternal health services in Nigeria-looking beyond individual and household factors. BMC Pregnancy and Childbirth. 2009 Dec; 9: 1-3. doi:10.1186/1471-2393-9-43.

Khan N and Abbas M. Availability and utilization of primary health care services in the rural areas of district Peshawar-A case study. Sarhad Journal of Agriculture (Pakistan). 2007; 23(4): 1217-1123.

Abodunrin OL, Akande TM, Osagbemi GK. Awareness and perception toward referral in health care: a study of adult residents in Ilorin, Nigeria. Annals of African Medicine. 2010 Jul; 9(3): 176-80. doi: 10.4103/1596-3519.68359.

Furber AS. Referral to hospital in Nepal: 4 years' experience in one rural district. Tropical Doctor. 2002 Apr; 32(2): 75-8. doi: 10.1177/004947550203200205.

Qureshi RN, Sultanali RS, Hoodbhoy Z, Bano R, Jabeen N. Referral pattern of emergencies in obstetrics: implications for defining scope of services and policy. Journal of the Pakistan Medical Association: JPMA. 2016 Dec; 66(12): 1606.

Farahat T, Al-Kot M, Aldemerdash M. Current situation of the referral system in family practice in Shebein El-Koum District, Menoufia Governorate, Egypt. Menoufia Medical Journal. 2015 Apr; 28(2): 360. doi: 10.4103/1110-2098.163885.

Eskandari M, Abbaszadeh A, Borhani F. Barriers of referral system to health care provision in rural societies in Iran. Journal of Caring Sciences. 2013 Sep; 2(3): 229. doi:10.5681/JCS.2013.028

Downloads

Published

2023-05-31
CITATION
DOI: 10.54393/pjhs.v4i05.406
Published: 2023-05-31

How to Cite

Kakakhel, S. I. ., Mahmood, H. ., Khan, J. ., Makey, G. ., Arif, M. ., Jamil, S. ., Habib, F. ., Raisani, S. A. ., Shaheen, D. Y. ., & Diba, F. . (2023). Assessment of Referral Patterns and Utilization of Basic Health Facilities in the Outpatient Department of a Tertiary Care Hospital: A Cross Sectional Study : Referral Patterns and Utilization of Basic Health Facilities. Pakistan Journal of Health Sciences, 4(05), 42–46. https://doi.org/10.54393/pjhs.v4i05.406

Issue

Section

Original Article

Plaudit

Most read articles by the same author(s)