Evaluating referrals between rural district hospitals and a regional hospital in South Africa

African Journal of Primary Health Care & Family Medicine

 
 
Field Value
 
Title Evaluating referrals between rural district hospitals and a regional hospital in South Africa
 
Creator Ngoie, Kambola D. Jenkins, Louis Schoevers, Johann
 
Subject Family medicine; rural health; district health; primary care referrals; district hospitals; regional hospital; rural districts; South Africa
Description Background: Efficient referral systems are essential for improving healthcare and patient outcomes, especially in resource-limited settings where access to public specialist care is limited by too few specialists, growing populations and constrained resources impacting non-emergency and emergency referrals. District hospitals (DHs) must ensure that patients receive the appropriate level of care. High-quality referral systems are necessary for the cost-effective flow of patients between district and regional hospitals (RHs).Aim: This study aimed to evaluate emergency and non-emergency patient referral processes between DHs and the RH in two districts in South Africa.Setting: Ten DHs and the RH in the Garden Route and Central Karoo districts in South Africa.Methods: A mixed-methods design incorporated quantitative survey data and qualitative thematic analysis to provide a comprehensive understanding of referral processes. The study population included all doctors working at 10 DHs and the RH, with 120 voluntary participants.Results: Key findings revealed disparities in referral satisfaction between emergency (66%) and non-emergency (59%) referrals. Communication breakdowns and systemic barriers hindered timely access to specialist care, mismatched expectations and understanding, coupled with inconsistent referral guidelines. Inadequate capacity building increased inappropriate referrals.Conclusion: Communication breakdowns and differing expectations between DHs and the RH regarding available resources and services negatively impacted referrals. Improved communication, targeted outreach, capacity-building initiatives, stronger collaborative relationships and standardisation of processes could enhance patient referral efficiency.Contribution: This work adds new knowledge to patient referrals between rural district and regional hospitals in resource-limited contexts, highlighting the complexity of the referral process.
 
Publisher AOSIS
 
Contributor N/A
Date 2025-07-09
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Mixed methods
Format text/html application/epub+zip text/xml application/pdf application/pdf application/pdf
Identifier 10.4102/phcfm.v17i1.4956
 
Source African Journal of Primary Health Care & Family Medicine; Vol 17, No 1 (2025); 11 pages 2071-2936 2071-2928
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://phcfm.org/index.php/phcfm/article/view/4956/8400 https://phcfm.org/index.php/phcfm/article/view/4956/8401 https://phcfm.org/index.php/phcfm/article/view/4956/8402 https://phcfm.org/index.php/phcfm/article/view/4956/8410 https://phcfm.org/index.php/phcfm/article/view/4956/8411 https://phcfm.org/index.php/phcfm/article/view/4956/8403
 
Coverage Africa; South Africa; Western Cape; Garden Route and Central Karoo districts 2024 N/A
Rights Copyright (c) 2025 Kambola D. Ngoie, Louis Jenkins, Johann Schoevers https://creativecommons.org/licenses/by/4.0
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