Patient views regarding the down referral system of patients with chronic diseases at Dr George Mukhari Academic Hospital, Ga- Rankuwa, South Africa

Abstract

If the referral system between healthcare facilities is not operating efficiently it could result in the underuse of lower level facilities and the overuse of higher-level facilities. Studies have shown that it is difficult to have a properly functioning patient referral system when patients by-pass the system. This study sought to determine patient views regarding the down referral system of patients with chronic diseases at Dr George Mukhari academic hospital (DGMAH). A quantitative study using a cross- sectional descriptive design was conducted. The first 450 stable patients from the various OPD clinics, having a six months repeat prescription, willing to participate in the study and provided consent completed the researcher-administered questionnaire. Descriptive statistics were used to analyse data. The majority of the patients interviewed in the study were females (78.2%), 51 years and older (70%). Fifty two percent of patients (210) complied with the down referral system because it is convenient for them; 60.9% of patients reported that non-availability of medicines at clinics was the main reason for it not being a good system and 22% of the patients came back to the hospital if they did not get medicine from the clinic. Poor service and bad staff attitudes (54.6%) were the most listed reasons by patients for regarding clinic staff as being incompetent. Non-availability of medicines and poor service delivery at clinics were the main reasons for patients returning to the hospital to collect medicine.

Keywords: Down referral system, patient views, stable chronic patients, DGMAH.