Abstract:
Background:-The WHO Expert Committee on the Role of Hospitals at the First Referral
Level identified the key problems within the referral system are over- loading of hospitals
with inappropriate self- referrals, poorly-judged referrals, leading to by-passing of those
levels and inadequate flow of information to and from the hospital.
Objective: - The purpose of this study is to assess magnitude and determinants of selfreferral of patient at Nekemte General Hospital, East wollega, Ethiopia, 2014.
Method and materials: A hospital based cross sectional study was conducted from April
16-30, 2014. Four hundred twenty two patients attending Nekemte hospital were
selected using systematic sampling technique. Data were collected using structured and
pre-tested questionnaire. Six data collectors and one supervisor were trained and involved
in the data collection process. Data were entered and analyzed with bivariate and
multivariate logistic regression using SPSS version 20.0-computer software.
Result: Response rate was 99.8%. A total 346 (82%) of respondents at Nekemte general hospital
were self-referred. Among respondents 218(51.7%) were female. Patients who knew closer health
facility as the first referral were 76% less likely to self refer themselves to the Nekemte General
Hospital as compared with those who did not know it. Those who obtained information on the
referral system from health worker were 35% less likely to self refer themselves to Nekemte
General Hospital.
Conclusion and Recommendation: obtaining laboratory test service, drug at closer
health facility, knowing the closer health facility as first referral level and the obtaining
of health education on referral system from health worker were found to be significantly
associated with self-referral to Nekemte General Hospital. Ensuring primary level health
care particularly health centers with adequate drug supply and laboratory services, health
workers should take measures to improve awareness of patient on referral system.
