Quality of Medical Referrals to the Ga West Municipal Hospital-Amasaman

Abstract

Introduction: Medical referral system is a vital and critical aspect of patient care from a primary health care professional to the tertiary care provider or specialist. Referral letters have become the most common means by which health care providers communicate with each other on patient information transfer. Objectives: The aim of this research is to determine the quality and appropriateness of medical referrals to the Ga West municipal hospital, Amasaman. Methods: This research is a cross sectional study on referral letters presented by patients to the Ga West municipal hospital, Amasaman. In all 163 referrals were assessed, these were referrals the hospital recorded from January 2018 to December 2018. A fifteen (15) item question was used to assess the adequacy of information contained in the referral letter. The letters were also evaluated with a five question item to determine their appropriateness. The folders of the referred cases were also reviewed for evidence of feedback to the referring facilities. Results: Out of the 163 letters presented at the facility, only 38.9% had adequate information contained in them. 45.66% of the written referrals were appropriately referred. The rate of referrals rose across the different quarters of the year. The first quarter recorded 31.9 per 10,000 patient inflow, 41.3(second quarter), 77.3(third quarter) and the last quarter (80.7). None of the folders contained feed back to the referring facilities, indicating a zero referral feedback Conclusion: Overall rating of the referral letters showed that, majority of the referrals to the Ga West municipal hospital did not meet the recommended criteria. Poor referral letters and zero feedback in the referral process have a potential of affecting patient treatment outcome. It is therefore recommended that, GHS and its stakeholders should retrain its clinical staff on how to write good referral letters and also provide feedback to the referring facilities for proper management of patient. Keywords: Referrals, Rate, Quality, Appropriateness, Feedback, Amasaman, Ghana