Magnitude and Determinants of Self-Referral of Patients at a General Hospital, Western Ethiopia
Science Journal of Clinical Medicine
Volume 4, Issue 5, September 2015, Pages: 86-92
Received: Aug. 1, 2015;
Accepted: Aug. 10, 2015;
Published: Aug. 19, 2015
Views 3673 Downloads 120
Wolkite Olani Abdi, Eastern Wellega, Oromia Regional State, Ethiopia
Waju Beyene Salgedo, Department of Health Economics Management and Policy, College of Health Sciences, Jimma University, Jimma, Ethiopia
Gebeyehu Tsega Nebeb, Department of Health Economics Management and Policy, College of Health Sciences, Jimma University, Jimma, Ethiopia
Follow on us
Background. Self-referrals may cause the primary level health care to be under-utilized and hospitals over used, congested and overburdened, leading to an escalation of health care costs. Large patient load in referral hospitals causes human and physical resources to be stretched to capacity, which results in compromising the quality of care they provide to patients. The aforementioned problem is well observed in the study area but the phenomenon has not been formally studied. Therefore, this study aimed to assess the magnitude and determinants of self-referral of patient to the secondary referral level. Method and materials: A hospital based cross sectional study was conducted from April 16-30, 2014. Four hundred twenty two patients were selected using systematic sampling technique. Data was collected using structured and pre-tested questionnaire. Six data collectors and one supervisor collected the data. Data was analyzed using SPSS for window version 20 computer software. Simple and multiple logistic regressions were used to measure the association of variables at 95 percent confidence interval and p-value of <0.05. Ethical clearance was obtained from the ethics committee of the college of Health sciences, Jimma University, in Ethiopia. Result: A total of 422 patients responded to the interview making the response rate 99.8%. Three hundred forty six (82%) of the participants were self-referred among which 218(63.0%) were females. Three hundred and twenty two (93%) of the self-referred patients bypassed the first rung in the referral ladder despite knowledge of the closer health facility as their first level of care. Those who obtained information on the referral system from health workers were 3.5 times less likely to self refer themselves to the general referral study Hospital. Conclusions: Obtaining laboratory test, availability of drugs at closer health facility, knowing the closer health facility is first referral level and obtaining health education on referral systems from health worker were found to be significantly associated with self-referral to Nekemte General Hospital. Thus it is recommended that the healthcare leaders should strive to ensure better availability of drug supply and laboratory tests at local health centers and health care providers should work hard to make their community aware of the referral system to get efficient and effective service at a closer heath facility.
Self-Referral, Nekemte, Ethiopia
To cite this article
Wolkite Olani Abdi,
Waju Beyene Salgedo,
Gebeyehu Tsega Nebeb,
Magnitude and Determinants of Self-Referral of Patients at a General Hospital, Western Ethiopia, Science Journal of Clinical Medicine.
Vol. 4, No. 5,
2015, pp. 86-92.
Akande TM. Referral system in Nigeria: a study of tertiary health facility. Annuals of African Medicine 2004.
Murray SF, Pearson SC. Maternity referral systems in developing countries: current knowledge and future research needs. Social Science & Medicine 2006; 62(9): 2205-2215.
Mahlmeister, L. The process of triage in perinatal settings: clinical and legal issues. J Perinat Neonatal Nurs. 2002; 13:13-30.
Osibogun A. The role of health center in the rational use of health resources. Paper presented at the 17th Annual Scientific Conference of Association of Community Physicians of Nigeria. March 1996.
Akin, John and Paul Hutchinson (1999) “Health-care Facility Choice and the Phenomenon of Bypassing”, Health Policy and Planning, 14 (2): 135-51.
S Siddiqi, AA Kielmann, Ms Khan, et al. The effectiveness of patient referral in Pakistan. Health Policy and Planning 2001; 16: 193-198.
Atkinson S et al. The referral process and urban care in sub-Saharan Africa: The case of Lusaka, Zambia (1999). 49(1):27–38.
Leonard K, Mliga G, Haile Mariam D. Bypassing health centers in Tanzania: Revealed preferences for observable and unobservable quality. Journal of African Economies 2002; 11 (4):441-471.
Federal Ministry of Health. Health service Development program IV.Addis Ababa Ethiopia 2010.
Federal Ministry of Health. Health policy of the Transitional government of Ethiopia, Sept 1993.
Federal Ministry of Health, Ethiopia: Policy, Planning and Finance General Directorate. The 2008/09 Annual Review Meeting (ARM) Performance Report. 2010. Addis Ababa, Ethiopia.
Haile Mariam D. Bridging the availability-utilization gap: The issue of quality in the provision of health care. Addis Ababa, Ethiopia Ethiop J Health Dev 2011; 25(1).
Kahabuka C, Kvåle G, Karen MM, Sven GH. Why caretakers bypass Primary Health Care facilities for child care. Tanzania 2011.
Turin, Dustin R. Health Care Utilization: Analyzing the Kenyan Health System. Student Pulse Academic Journal 2010; 2.09.