{"title":"评估南非农村地区医院和区域医院之间的转诊情况。","authors":"Kambola D Ngoie, Louis Jenkins, Johann Schoevers","doi":"10.4102/phcfm.v17i1.4956","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong> Efficient 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).</p><p><strong>Aim: </strong> This study aimed to evaluate emergency and non-emergency patient referral processes between DHs and the RH in two districts in South Africa.</p><p><strong>Setting: </strong> Ten DHs and the RH in the Garden Route and Central Karoo districts in South Africa.</p><p><strong>Methods: </strong> A 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.</p><p><strong>Results: </strong> Key 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.</p><p><strong>Conclusion: </strong> Communication 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.Contribution: This work adds new knowledge to patient referrals between rural district and regional hospitals in resource-limited contexts, highlighting the complexity of the referral process.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e11"},"PeriodicalIF":1.7000,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339770/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluating referrals between rural district hospitals and a regional hospital in South Africa.\",\"authors\":\"Kambola D Ngoie, Louis Jenkins, Johann Schoevers\",\"doi\":\"10.4102/phcfm.v17i1.4956\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong> Efficient 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).</p><p><strong>Aim: </strong> This study aimed to evaluate emergency and non-emergency patient referral processes between DHs and the RH in two districts in South Africa.</p><p><strong>Setting: </strong> Ten DHs and the RH in the Garden Route and Central Karoo districts in South Africa.</p><p><strong>Methods: </strong> A 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.</p><p><strong>Results: </strong> Key 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.</p><p><strong>Conclusion: </strong> Communication 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.Contribution: This work adds new knowledge to patient referrals between rural district and regional hospitals in resource-limited contexts, highlighting the complexity of the referral process.</p>\",\"PeriodicalId\":47037,\"journal\":{\"name\":\"African Journal of Primary Health Care & Family Medicine\",\"volume\":\"17 1\",\"pages\":\"e1-e11\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339770/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"African Journal of Primary Health Care & Family Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4102/phcfm.v17i1.4956\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PRIMARY HEALTH CARE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"African Journal of Primary Health Care & Family Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/phcfm.v17i1.4956","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
Evaluating referrals between rural district hospitals and a regional hospital in South Africa.
Background: Efficient 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).
Aim: This study aimed to evaluate emergency and non-emergency patient referral processes between DHs and the RH in two districts in South Africa.
Setting: Ten DHs and the RH in the Garden Route and Central Karoo districts in South Africa.
Methods: A 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.
Results: Key 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.
Conclusion: Communication 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.Contribution: This work adds new knowledge to patient referrals between rural district and regional hospitals in resource-limited contexts, highlighting the complexity of the referral process.
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