REASONS OF PATIENTS TRANSFER FROM PERIPHERAL TEACHING AND NON TEACHING HOSPITALS TO A SURGICAL UNIT, LADY READING HOSPITAL PESHAWAR: A PILOT STUDY

Methodology: This is a descriptive cross-sectional study conducted in surgi -cal unit “C” Lady Reading Hospital (LRH) Peshawar from February 28 to Sep-tember 14, 2014, using consecutive non-purposive sampling technique. All patients admitted in our unit living outside the catchment area of Peshawar were included. Age, gender, address, reason for referral and perception of the patients about Lady Reading Hospital Peshawar was recorded on a proforma. Data was analyzed using SPSS version 20. Mean and standard deviation was calculated for quantitative output responses and frequency and percentages for qualitative output responses. Chi-square test was applied on the variables when compared and p value of <0.05 was considered significant. Results: Total patients received in the study period of (six and half months) were 195.Out of these 75.4% were male. The mean age of patients was 37.2+ 17.49 years. The percentage admitted via emergency was 88.7%. Out of 195 patients, 147(75.4%) attended a health facility before coming to LRH. The rea-sons given for referral was lack of equipment, lack of staff, lack of ICU, lack of specialty, lack of out of hours services and seropositivity given in 88(59.8%), 74(50.3%),71(48.2%), 70(47.6%), 70 (47.6%) and 04 (2.7%) patients respectively. Dissatisfaction towards the local health facilities was shown by 137 (70.3%). Conclusion: The peripheral health care system is being underutilized result-ing in excessive burden on tertiary care health facilities. It is therefore import -ant to address the problems and to implement a structured referral system.

[1]  I. Feldman,et al.  Social inequalities in self-reported refraining from health care due to financial reasons in Sweden: health care on equal terms? , 2014, BMC Health Services Research.

[2]  A. Leung,et al.  Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study , 2014, BMJ Open.

[3]  L. Borgquist,et al.  Distance to hospital and socioeconomic status influence secondary health care use , 2013, Scandinavian journal of primary health care.

[4]  A. P. D. Ponce de Leon,et al.  Socioeconomic differences in healthcare utilization, with and without adjustment for need: An example from Stockholm, Sweden , 2013, Scandinavian journal of public health.

[5]  D. Chae,et al.  Barriers to Health Care among Asian Immigrants in the United States: A Traditional Review , 2013, Journal of health care for the poor and underserved.

[6]  A. Scott,et al.  The effect of financial incentives on the quality of health care provided by primary care physicians. , 2011, The Cochrane database of systematic reviews.

[7]  T. Faresjö,et al.  Exploring factors that affect hospital referral in rural settings: a case study from Norway. , 2009, Rural and remote health.

[8]  I. Ovhed,et al.  Differences in referral rates to specialised health care from four primary health care models in Klaipeda, Lithuania , 2008, BMC family practice.

[9]  Kakoli Roy,et al.  Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India. , 2008, Social science & medicine.

[10]  M. Geitona,et al.  Determinants of healthcare utilization in Greece: Implications for decision-making , 2007, The European journal of general practice.

[11]  P. Austin,et al.  Patient, Physician, and Community Factors Affecting Referrals to Specialists in Ontario, Canada: A Population-Based, Multi-Level Modelling Approach , 2003, Medical care.

[12]  A. Furber Referral to Hospital in Nepal: 4 Years' Experience in One Rural District , 2002, Tropical doctor.

[13]  P. Jenkins,et al.  Strengthening health management: experience of district teams in The Gambia. , 1996, Health policy and planning.

[14]  Muhammad Abbas,et al.  AVAILABILITY AND UTILIZATION OF PRIMARY HEALTH CARE SERVICES IN THE RURAL AREAS OF DISTRICT PESHAWAR – A CASE STUDY , 2010 .

[15]  J M Grimshaw,et al.  Interventions to improve outpatient referrals from primary care to secondary care. , 2005, The Cochrane database of systematic reviews.

[16]  A. Stefanini District hospitals and strengthening referral systems in developing countries. , 1994, World hospitals and health services : the official journal of the International Hospital Federation.