The importance of patient referral from primary health care centers (PHCCs) to tertiary care hospitals is reflected in patient care and their follow up. Objectives of this study were to compare the referral rates from PHCCs to other hospitals and to compare the quality of referrals in terms of completeness and accuracy of diagnosis having Family Physicians (FPs) and PHCCs without FPs. This cross-sectional survey was conducted at 15 PHCCs using stratified random sampling. Referral sheets were assessed on 15 items for their completeness and quality filled by FPs, General Practitioner (GPs) and those not clear. T test and Mann Whitney U test were performed in SPSS 22 to see the mean difference.
Of the 1112 referral sheets assessed, a significant difference (p= 0.001) in the mean scores for completeness of referral sheets in PHCCs with FPs (8.55±1.77) and without FPs (8.18±1.69) was observed. No significant difference in the per month referral rates (p=0.315) was observed however, there is difference in the median scores (PHCC with FP 5.0(IQ=3.8) and PHCC without FP 8.4(IQ=10). Around 62% referral sheets filled by FPs were above acceptable level of completeness as compared to 35% of GPs. In conclusion, the quality of referral sheets is inadequate and needs improvement. This can be achieved by sensitizing the PHC physicians of this problem and realizing them of their role in the process.
Keywords: Family Physician, Primary care, Quality, Referral-consultation, Referral forms