E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki.

Abstract
Background: Referral system is facing difficulties worldwide. In Saudi Arabia, particularly, our doctors always complain of referral system.

Objective: To measure the referral rate from primary- to secondary health-care services, evaluate secondary health-care opinion regarding referral from primary care, and measure the feedback rate from secondary health-care physicians.

Materials and Methods: A cross-sectional approach was carried out, which included currently working doctors in a governmental secondary health-care hospital who received referral from primary-care centers in Taif, in addition to a manager of each primary health care center (PHCC) inside the Taif area. Data were collected by using two forms. The first form was a questionnaire that collected data from physicians. It included personal data of the doctors and doctors’ judgment regarding referral process in PHCC and what can improve the quality of referral system and make it more useful to the patients. The second form was a checklist used to collect data from managers of involved PHCC inside the Taif area.

Result: The study included 112 physicians working in secondary health-care governmental hospitals in Taif. Their age ranged between 25 and 60 years with a mean of 40.4 years and standard deviation of 9.2 years. Men represented 70.5% of them. The commonest reported reasons for referral from PHCCs were seeking specialized treatment (42.9%), more assessment of patients (40.1%), and diagnosis of difficult cases (21.4%). Almost three quarters of them (77.7%) considered referring notes to be more informative if the referring doctor was a family physician. More than half of the physicians (52.5%) reported that they never issued feedback notes to PHCCs regarding referred cases, whereas 20.8% of them reported that they always issued such notes. Older physicians (>50 years) provided feedback referral notes either always or sometimes at a significantly higher rate than younger physicians (76.5% versus 50% among those aged between 41 and 50 years and 30.8% among those aged 40 years or younger). The difference was statistically significant.

Conclusion: This study highlighted some of the inadequacies in the effectiveness of the referral system in a PHCC from the perspective of physicians working in governmental secondary-care hospitals in Taif and suggested various ways of dealing with them.

Key words: Referral, primary health care, secondary health care, government hospitals, Saudi Arabia


 
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REFERENCES
1. Jarallah JS. Referral from primary care to hospitals in Saudi Arabia: 1) quality of referral letters and feedback reports. J Family Community Med 1998;5(2):15-22. [Pubmed]    [PMC Free Fulltext]   
2. Lee T, Pappius EM, Goldman L. Impact of inter-physician communication on the effectiveness of medical consultations. Am J Med 1983;74(1):106-12. [DOI via Crossref]   
3. Byrd JC, Moskowitz MA. Outpatient consultation: Interaction between the general internist and the specialist. J Gen Intern Med 1987;2(2):93-8. [DOI via Crossref]   
4. Sears CL, Charlson ME. The effectiveness of a consultation: Compliance with initial recommendations. Am J Med 1983; 74(5):870-6. [DOI via Crossref]   
5. Epstein O. The transformation of letter writing with information technology. Br J Hosp Med 1989;41:177-81.
6. Kentish R, Jenkins P, Lask B. Study of written communication between general practitioners and departments of child psychiatry. J R Coll Gen Pract 1987;37(297):162-3. [Pubmed]    [PMC Free Fulltext]   
7. Jarallah JS. The quality of referral letters in two health centers in Riyadh. Ann Saudi Med 1991;11(6):658-62. [Pubmed]   
8. Khoja TAM, Al Shehri AM, Abdul-Aziz AF, Aziz KMS. Patterns of referral from health centres to hospitals in Riyadh region. East MediterrHealth J 1997;3(2):236-43.
9. Al-ShehriAM, Thomas M, Al-Ghuli A. Use and misuse of emergency services at King Fahd Hospital, Riyadh, Saudi Arabia. Saudi MedJ1991;13(1):21-4.
10. Kordy MN,Ibrahim MA,al-Gamal FM,Bahnassy A,Milaat W. A study of the morbidity patter no freferred patients and the effectiveness of the referral system inprimary health care centers. J Egypt Public Health Assoc1992;67(5-6):709-24.
11. Baghdadi L, Baghdadi R. Referral System from PHC to Hospital in Holy Makkah. Mecca, Saudi Arabia: Umm Al-Qura University, Faculty of Medicine, 2007.
12. Grumbach K, Selby JV, Damberg C, Bindman AB, Quesenberry C, TrumanA, et al. Resolving the gate keeper conundrum: What patients value in primary care and referrals to specialists. JAMA 1999;282(3):261-6. [DOI via Crossref]    [Pubmed]   
13. Kvamme OJ, Olesen F, Samuelson M. Improving the interface between primary and secondary care: A statementfrom the European Working Party on Quality in Family Practice (EQuiP). Qual Health Care 2001;10(1):33-9. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
14. OÂ’Donnell CA: Variation in GP referral rates: What can we learn from the literature? FamPract 2000;17(6):462-71. [DOI via Crossref]    [Pubmed]   
15. Mahfouz AA, Abolfotouth MA, Al-Khozayem AA, Al-Erian RA. Referral system in the Asir Region, Saudi Arabia: A study on hospitalsÂ’ referral coordination offices. Saudi Med J 1993;14:237-9.
16. Khattab MS, Abolfotouh MA, Al-Khaldi YM,Khan MY. Studying the referral system in one family practice center in Saudi Arabia. AnnSaudi Med1999;19(2):167-70.
17. Wilkins D, Smith AG. Variation in general practitionersÂ’ referral rates toconsultants. J R Coll Gen Pract 1987;37(301):350-3.
18. Moore AT, Roland MO. How much variation in referral rates amonggeneral practitioners is due to chance? BMJ 1989;298(6672):500-2. [DOI via Crossref]    [PMC Free Fulltext]   
19. Stott NCH. Help-seeking behaviour. In: Primary Health Care: Bridgingthe Gap Between Theory and Practice. Berlin: Springer-Verlag, 1983. pp. 43-51. [DOI via Crossref]   
20. Ringberg U,Fleten N, Deraas TS, Hasvold T, Førde O. High referral rates to secondary care by generalpractitioners in Norway are associated with GPsÂ’ gender and specialist qualifications in family medicine, a study of 4350 consultations. BMC Health Serv Res 2013;13:147. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
21. Jarallah JS. The quality of referral letters in two health centers in Riyadh. Ann Saudi Med 1991;11(6):658-62. [Pubmed]   
22. Vehvilainen AT, Kumpusalo EA, Voutilainen SO, Takala JK. Does the doctorsÂ’ professional experience reduce referral rates? Evidence from the Finnish referral study. Scand J Prim Health Care 1996;14:13-20. [DOI via Crossref]   
23. Rosemann T, RĂĽter G, Wensing M, Szecsenyi J. Referrals from primary to secondary care. DtschArztebl 2006;103(37):A2387-92.

How to Cite this Article
Pubmed Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki. Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA. Int J Med Sci Public Health. 2015; 4(10): 1457-1463. doi:10.5455/ijmsph.2015.19062015302


Web Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki. Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA. http://www.ijmsph.com/?mno=196153 [Access: January 29, 2020]. doi:10.5455/ijmsph.2015.19062015302


AMA (American Medical Association) Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki. Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA. Int J Med Sci Public Health. 2015; 4(10): 1457-1463. doi:10.5455/ijmsph.2015.19062015302



Vancouver/ICMJE Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki. Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA. Int J Med Sci Public Health. (2015), [cited January 29, 2020]; 4(10): 1457-1463. doi:10.5455/ijmsph.2015.19062015302



Harvard Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki (2015) Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA. Int J Med Sci Public Health, 4 (10), 1457-1463. doi:10.5455/ijmsph.2015.19062015302



Turabian Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki. 2015. Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA. International Journal of Medical Science and Public Health, 4 (10), 1457-1463. doi:10.5455/ijmsph.2015.19062015302



Chicago Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki. "Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA." International Journal of Medical Science and Public Health 4 (2015), 1457-1463. doi:10.5455/ijmsph.2015.19062015302



MLA (The Modern Language Association) Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki. "Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA." International Journal of Medical Science and Public Health 4.10 (2015), 1457-1463. Print. doi:10.5455/ijmsph.2015.19062015302



APA (American Psychological Association) Style

Osama MohammadAlGhamdi, BasimMatar AL-Malki, Ammar EidNahhas, Adel Dakhilallah AL-Malki (2015) Rate of referral from primary health care to secondary health care among governmental hospitals in Taif governorate, KSA. International Journal of Medical Science and Public Health, 4 (10), 1457-1463. doi:10.5455/ijmsph.2015.19062015302





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