Title: Pattern of Referrals in a District Hospital & the Factors Responsible
Authors: Dr Rakesh Kumar Sharma, Dr Shahid Anjum, Dr Rashid Anjum
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.46
Abstract
Background: Regionalization envisages a two-way flow of Patients & Services designates as “Referral in” and “Referral out” cases. “Referral in” generally means Patients from Sub center, Primary Health Centre, & Community Health Centre Referred to District Hospital for Specialized care.” Referred out” generally means Patients from District Hospital to Higher Centers like Medical College & other Postgraduate Institutions for Super Specialized Treatment.
Methodology: A prospective study was undertaken at district hospital with data collected for a 12-month period (MAY 2013 - APRIL 2014) to study (1) the rate of Referrals in a District Hospital & (2) Factors responsible for increased Referrals.
Results: Absence of Radiologist, Lack of Anesthetist, Shortage of rare Blood groups in Blood bank, Lack of Sophisticated Ventilators support, Cardiac monitors, Dialysis facilities, etc. have been the Major Factors for increased “Referral out” cases to Medical College.
Conclusion: Too much “Referral in” cases from all the PHC’s & CHC’s to District Hospital Cause Exhaustion of local supplies & Quality of Patient care suffers. Frequent “Referral out” cases add up to Fuel wastage & Pilferage resulting in Professional Misconduct & misuse of Ambulance services.
Keywords: Hospital, Regionalization, Referral, Radiologist, Anesthetist, Ventilators, Pilferage.
References
- Groene O.; Barbero M.G.; Health promotion in Hospitals: Evidence & Quality Management; Europe; May 2005 ;page: 1-120.
- Sakharkar BM; Principles of Hospital Administration & Planning; 2009; Vol.2; page:23-24.
- Al-Mazrou, Y., S. Al-Shehri, and M. Rao. 1990. Principles and Practice of Primary Health Care. Riyadh: Al-Helal Press.
- Mulligan, J., J. Fox-Rushby, T. Adam, B. Johns, and A. Mills. 2003. “Unit Costs of Health Care Inputs in Low and Middle Income Regions.” Working Paper 9, Disease Control Priorities Project, Fogarty.
- National Department of Health, South Africa. 2003. “Strategic Framework for the Modernisation of Tertiary Hospital Services”. National Department of Health, South Africa, Pretoria.
- Stefanini, A. 1994. “District Hospitals and Strengthening Referral Systems in Developing Countries.”World Hospitals 30 (2): 14–19.
- Rashid Anjum, Sharma V, Jindal R, Singh TP, Rathee N. Epidemiologic pattern of paediatric supracondylar fractures of humerus in a teaching hospital of rural India: A prospective study of 263 cases. Chin J Traumatol. 2017; 20: 158-160.
- Barnum, H., and J. Kutzin. 1993. Public Hospitals in Developing Countries: Resource Use, Cost, Financing. Baltimore: Johns Hopkins University Press.
- Muraleedharan, V. R. 1999. “Characteristics and Structure of the Private Hospital Sector in Urban India: A Study of Madras City.” Small Applied Research Paper 5, Abt Associates, Partnerships for Health Reform Project, Bethesda, MD.
- Walford, V., and K. Grant. 1998. “Health Sector Reform: Improving Hospital Efficiency.” London: Department for International Development, Health Sector Resource Centre.