Evaluation of the referral system in Iran's rural family physician program

A study of Jiroft University of Medical Sciences

Authors

  • Ehsan Movahed Ph.D. Student of Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Keywords:

Referral system, Family physician, Healthcare

Abstract

Background and objective: Referral systems are relatively easy in terms of design, but implementing them is extremely difficult. Considering the three levels of primary healthcare, access of people to specialized services through a referral system is possible. With regard to the importance of a referral system in a family physician program, this study was performed to assess the function of the referral system in the family physician program in Jiroft University of Medical Sciences.

Methods: This cross-sectional study was performed in the first half of 2014. The sample size included 700 patients selected using multistage sampling. Firstly 30% of health centers were randomly selected as a cluster. Then, the patients were randomly selected from each cluster. The study data were collected through a questionnaire consisting of 2 parts - demographic variables and the rules of the referral system. Data were analyzed using descriptive statistics, Chi Square, and Logistic Regression.

Results: From 700 patients who received the level 2 services, 69% of cases were female and 31% were male. One hundred eighty-two cases (26%) had referral form from health house. Only 56.4% of persons referred to the centers because of diagnosis of the family physician. For 34% of cases, the specialists wrote the results of their evaluation in feedback form. Four hundred sixty-three patients did not return to their family physician because of lack of knowledge. 

Conclusion: The referral situation to level 2, in the present study was poor. Ease of access to specialized services level 2, and educational intervention for healthcare staff and familiarizing people with the objectives of the family physician program and referral system are recommended.

References

Davoudi S. Introduction to health sector reform. Tehran: Asare Mouaser Pub; 2006: 233-7.

Panahi B. Operational process of the social security system. J Soc Secur. 2009; 1(1): 91-9.

Ferdosi M, Vatankhah S, Khalesi N, Ayoobian A. Designing a referral system management model for

direct treatment in social security organization. J Mil Med. 2012; 14(2): 129-35.

Physician Instruction F. Iran: Ministry of Health and Medical Education. Version. 2011; 12: 4-102. 5) Karimi S. Comparative Study of the Situation Villagers Access to Health Services in Selected Countries

and Provide a Model for Iran, Ph.D Dissertation. Tehran: Azad Islamic Univercity of Science and Research

Branch; 2007.

Raeisee P, Motlagh M, Kabir M. Evaluation of the performance of referral system in family physician

program in Iran University of Medical Sciences: 2009. Hakim Research Journal. 2010; 13(1): 19-25.

Jolaee H, Alizadeh M, Falah Zadeh M, Baseri A, Sayyadi M. Assessment of clinical skills province of

Family Physicians clinical test based on the observed (OSCE) Journal of Medical Education Developmalet

Center. Strides Dev Med Educ. 2010; 7(2): 92-8.

Mohammadi Sh, Mohammadi Sh, Bahrami S, Amiri A, Shahri A. Knowledge and attitudes of health

insurance executives and medical universities in the province Kurdistan & Qazvin and dependent hospitals

in implemmentation physician family plan. Advances in Natural and Applied Sciences. 2014; 8(7): 827-34.

Nasrollahpour Shirvani D, Ashrafian Amiri H, Motlagh ME, Kabir MJ, Maleki MR, Shabestani Monfared

A, et al. Evaluation of the function of referral system in family physician program in Northern provinces of

Iran: 2008. Journal of Babol University of Medical Sciences. 2010; 11(6): 46-52.

Motlagh E, Nasrollahpour Shirvani S, Ashrafian Amiri H, Kabir M, Shabestani Monfared A, Nahvijoy A.

Satisfaction of family physicians (FPs) about effective factors on activation of FP program in medical

universities. Journal of Guilan University of Medical Sciences. 2011; 19(76): 48-55.

Mirzaie K. Research, Researching & Writing. Tehran: Jameheshenasan Publication; 2009.

Nasrollahpour Shirvani D, Ashrafian Amiri H, Kabir M, Shabestani Monfared A. To evaluate the quality of

family physician program in Northern Provinces of Iran; 2008. Back to cited text. (22): 91-102.

Chaman R, Amiri M, Raei DM. The national family physician and the quality of referral system. 2012:

-90.

Alidoosti M, Tavassoli E, Delaram M, Najimi A, Sharifirad G. The relationship between satisfaction and

knowledge about family-doctor program in Shahr-e-Kord. Zahedan Journal of Research in Medical

Sciences. 2011; 13(6): 36-9.

Shams A, Mofid M, Rejlian F. Survey of referal system influenced factors from the perspective of

referrings of Isfahan educatinal hospitals. Health Information Management. 2011; 7: 669-78.

Hasan Zadeh A. People share from medical expenses. Atiye Weekly. 2006; 510.

Khosravi S, Amiresmaeili M, Yazdi Feyzabadi V. Performance evaluation and insurance plans of rural

family physicians: case study of kerman medical sciences university. Paper presented at: Proceedings of the

Role of Family Physicians in Health Systems Congress. 2012: 13-4.

Raeesi P, Nasrollahpour Shirvani D, Kabir M. To evaluate the quality of family physician program in Iran

University of Medical Sciences. Tehran. Reported Resesrch Project of Iran University of Medical Sciences.

; 792.

Hafezi Z, Asqari R, Momayezi M. Monitoring performance of family physicians in Yazd. Toloo-e- Behdasht. 2009; 8: 16-25.

Manca DP, Varnhagen S, Brett-MacLean P, Allan GM, Szafran O, Ausford A, et all. Rewards and

challenges of family practice Web-based survey using the Delphi method. Can Fam Physician. 2007; 53(2):

-86.

H HF. Performance evaluation of family physician program in Imam Khomeini's Relief Committee Yazd

province. Azad University. 2005; 24.

Leibowitz R, Day S, Dunt D. A systematic review of the effect of different models of after-hours primary

medical care services on clinical outcome, medical workload, and patient and GP satisfaction. Fam Pract.

; 20(3): 311-7. doi: 10.1093/fampra/cmg313. PMID: 12738701.

Published

2022-01-18

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