Doctors’ experiences regarding patient referral to tertiary care in Pretoria, South Africa

Abstract

Background: Patient referral is an essential component of patient care that cannot be underscored. Despite the fact that the regulations and steps involved are well known, little is known about the experiences of referring doctors during the process, as well as the factors that support or impede the referral. This study aimed to investigate doctor’s experiences regarding patient referral to tertiary care in Pretoria, South Africa.

Methods: A qualitative study using a descriptive phenomenology design and involving one-on-one interviews with eight doctors from Jubilee District Hospital who had referred patients to Dr George Mukhari Academic Hospital, in Pretoria, South Africa.

Results: Eight themes were identified from the analysis: estimated time taken to refer patient, attitudes of the receiving doctors towards patient referral, applicability of the receiving doctors’ advice prior to the referral, referring doctors’ perceptions regarding the receiving doctors’ attitudes towards patient referral, consequences of delays on patient care; strategies to address referral issues, experience regarding transportation of patients being referred and recommendations to improve the referral system. These are further expanded upon by six related sub-themes.

Conclusion: The referral process from a district hospital (Jubilee Hospital) to a tertiary care (Dr George Mukhari Academic Hospital) is onerous, with barriers being experienced at almost every step. A variety of issues hindered this process, including administrative, logistical and communication barriers that left referring doctors almost demotivated.

Contribution: The challenging experiences from referral highlight the significance of paying close attention to patient referral in order to avoid compromising patient care.