Referral Decision-Making: An Assessment of Family Physicians in a Tertiary Hospital in Nigeria

Family physicians offer first contact, comprehensive and coordinated care to patients, and refer those in need of further specialist care to specialists in other clinical departments. This referral decision-making is dependent on certain factors which can lead to variations in the pattern of referrals with impact on the coping capacity of a health facility. This study sought to assess the factors influencing referral decision-makingof family physicians in a tertiary hospital in Nigeria.

This was a descriptive cross-sectionalstudy of Family physicians in a tertiary hospital in Nigeria. It utilized a semi-structured, pre-tested self-administered questionnaire to obtain information on respondents' socio-demographic characteristics and factors that influenced respondents' referral decision. IBM SPSS Statistics version 22.0 (Chicago, IL, USA) statistical software was utilized for data analysis. A p-value of less than 0.05 was considered statistically significant.

The most reported factors that influenced the clinical decision of respondents to refer patients were the need for definitive treatment or surgery, 35(94.6%) and the need for a specific investigation,26 (70.3%). The least stated factors were: to save cost, patient's gender, patient's attitude and poor adherence to treatment plan, with equal proportions of 2.7% respectively.

The most reported factors that influenced the clinical decision of respondents to refer patients were the need for definitive treatment or surgery, and the need for a specific investigation. Work status and the length of practice in Family medicine were also found to play a role in the clinical decision of respondents to refer a patient.