A STUDY ON THE EFFICIENCY OF COMMUNITY TO HOSPITAL REFERRAL SYSTEM IN THE CATCHMENT AREA OF DODOMA HOSPITAL, TANZANIA

Abstract

Unnecessary or delayed hospital admissions are prevented by an efficient referral system.

Objectives of the study: Community Health Services (CHS) coverage, accessibility, efficiency, and interaction with the hospital.

Method: from March to June 1991 four Dodoma hospital paediatricians, using two structured questionnaires, studied 1,154 consecutive case of children (< 5 yrs) examined at the Outpatients Dept and 796 admitted to the Paediatric Ward.

Preliminary results: 1) Outpatients Dept: 84,5% of the children bypassed the CHS. Of them, 73% could have been treated in the CHS without needing to go directly to hospital. 2) Paediatric Ward: 66% of the children bypassed the CHS; 48% of these unreferred patients were admitted to the hospital with delay as compared to only 17% of the previously referred children. This delayed admission was followed by a high mortality rate within 48 hours (12,5%).

Conclusion: there is a need to study the factors which influence the flow of patients from the Community to the CHS and ultimately to the Hospital.

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