Referral patterns at a regional faith-based hospital in Western Kenya

Abstract

Aim: To assess the pattern and quality of patient referral at a regional faith-based hospital in Western Kenya. Methods: A prospective non-randomized study of patients referred into and out of Litein hospital from 1st June through 31st December 2016. Results: A total of 4,683 patients were admitted during the study period, with 147 `received referral' cases and 106 `sent referral' cases noted, with a referral rate of 3.1%. The majority of the received referrals were formal in nature (76%), initiated by doctors or clinical officers (74%), and had patient/relative input regarding the hospital to refer to (70%). The referral notes were mostly structured (90%) and legible (83%). Advice from the health care professional in the referring facility (36%, n=53), perceived good quality of care (21%, n=31), and presence of a valid insurance cover (8%, n=12) were the main reasons indicated by the patients for choosing our facility. The “sent referrals” were mainly due to need for specialized care (89%) or for proximity to family members/home (6%, n=6). Only 9% of the patients/relatives indicated that there was a significant delay in the initiation and execution of their referral from AIC Litein hospital. The referrals were initiated, predominantly, from the surgical departments (62%, n=66). Conclusion: The referrals to Litein Hospital, while comprising a minority of the patients admitted, were predominantly formal in nature, mostly initiated by medical personnel with the family members involved in decision making regarding the facility to be referred to.