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Evaluating referrals between rural district hospitals and a regional hospital in South Africa
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Evaluating referrals between rural district hospitals and a regional hospital in South Africa
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Journal Article
Evaluating referrals between rural district hospitals and a regional hospital in South Africa
2025
Overview
BackgroundEfficient referral systems are essential for improving healthcare and patient outcomes, especially in resource-limited settings where access to public specialist care is limited by too few specialists, growing populations and constrained resources impacting non-emergency and emergency referrals. District hospitals (DHs) must ensure that patients receive the appropriate level of care. High-quality referral systems are necessary for the cost-effective flow of patients between district and regional hospitals (RHs).AimThis study aimed to evaluate emergency and non-emergency patient referral processes between DHs and the RH in two districts in South Africa.SettingTen DHs and the RH in the Garden Route and Central Karoo districts in South Africa.MethodsA mixed-methods design incorporated quantitative survey data and qualitative thematic analysis to provide a comprehensive understanding of referral processes. The study population included all doctors working at 10 DHs and the RH, with 120 voluntary participants.ResultsKey findings revealed disparities in referral satisfaction between emergency (66%) and non-emergency (59%) referrals. Communication breakdowns and systemic barriers hindered timely access to specialist care, mismatched expectations and understanding, coupled with inconsistent referral guidelines. Inadequate capacity building increased inappropriate referrals.ConclusionCommunication breakdowns and differing expectations between DHs and the RH regarding available resources and services negatively impacted referrals. Improved communication, targeted outreach, capacity-building initiatives, stronger collaborative relationships and standardisation of processes could enhance patient referral efficiency.ContributionThis work adds new knowledge to patient referrals between rural district and regional hospitals in resource-limited contexts, highlighting the complexity of the referral process.
Publisher
AOSIS,African Online Scientific Information Systems (Pty) Ltd t/a AOSIS,AOSIS Publishing
Subject
/ Biology
/ Female
/ Health Care Sciences & Services
/ Health Services Accessibility
/ Hospitals, District - statistics & numerical data
/ Humans
/ Male
/ Medicine, General & Internal
/ Methods
/ Referral and Consultation - standards
/ Referral and Consultation - statistics & numerical data
/ Surveys
