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

Abstract

Background: 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-making of family physicians in a tertiary hospital in Nigeria.

Methodology: This was a descriptive cross-sectional study 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.

Results: 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.

Conclusion: 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.