Magnitude and determinants of self-referral of patients at Nekemte General Hospital, East wollega, western Ethiopia, 2014

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.