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Patient self-referral patterns in a developing country: characteristics, prevalence, and predictors
Mohammad Jahid Hasan1, Md Abdur Rafi2, Nahida Hannan Nishat3
1Tropical Disease and Health Research Center, Dhaka, 1100, Bangladesh. dr.jahid61@gmail.com.
BMC Health Services Research
|May 21, 2024
Summary
Nearly 60% of patients in Bangladesh bypass the referral system, opting for self-referral to tertiary care due to inadequate primary care facilities. This highlights a critical gap in healthcare access and efficiency.
Area of Science:
- Healthcare Management
- Public Health Policy
- Health Services Research
Background:
- Healthcare delivery in developing nations like Bangladesh is hampered by referral system challenges.
- Efficient healthcare access relies on a robust referral system, yet it faces significant obstacles.
Purpose of the Study:
- To assess the prevalence of self-referral among patients attending tertiary care hospitals in Bangladesh.
- To identify factors associated with self-referral to specialized healthcare services.
Main Methods:
- A cross-sectional study involving 822 patients at two tertiary care hospitals in Bangladesh.
- Data collected via semi-structured questionnaires, focusing on referral mode (self vs. institutional).
Main Results:
- 59% of patients were self-referred to tertiary care; 58% were unaware of the referral system.
- Inadequate treatment and facilities were key drivers for self-referral, particularly in private facilities.
- Urban residency, higher income, and proximity to facilities increased self-referral likelihood.
Conclusions:
- A significant proportion of patients self-refer to tertiary care in Bangladesh, driven by primary care deficiencies.
- Addressing primary care inadequacies is crucial to optimizing the healthcare referral system and improving patient access to specialized care.
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