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LEVEL OF CONSULTANCIES TO THE PATIENT REFERRED FROM OTHER HEALTH FACILITIES IN MEDICAL OPD SERVICES HOSPITAL LAHORE

Dr Muhammad Nadeem, Dr Muhammad Moaz Bin Khalid, Dr Khurram Hafeez

Introduction: Referral is the transfer of care for a patient from one clinician to another. Tertiary care is usually done by referral from primary or secondary medical care personnel. Various researches have been done on quality of referral and various factors influencing it i.e. factors related to physician and patient. But there is no significant work on analyzing the quality of consultation for referred patients. Purpose of our study is to evaluate the quality of consultation for the patients being referred from various other health facilities to Medical OPD of Services Hospital Lahore. Objectives: The aim of the study was to find outcome of level of consultancies to the referred patients from other health facilities and to assess the response of healthcare provider to the referred patients from other health facilities. Methodology: It was “Cross sectional” study. All the referred patients from other health care facilities visiting Medical OPD of Services Hospital, Lahore from 20 April-20 May 2017. Subjects were accessed by research team through non-probability convenient sampling techniques. Subjects were the patients who attended OPD of SHL. Written consent from the patients was obtained after informing them about the purpose of the study survey. Detail structured questionnaire was used to collect data. A face to face interview was conducted. The questionnaire was translated into local language for convenience. Results: A total of 34 referred patients were interviewed for the research according to availability of referred patients attending medical OPD of Services Hospital Lahore. 70.6% of patients were referred from within the Lahore and 29.4% were referred from periphery. The percentage of people having referral note with them was 47.1% and those referred without note was 52.9%. 35.3% of patients were referred from BHU. 26.5% from DHQ. 14.7% from THQ. 55.9% were using Hired private services. 26.5% were using self-transport. 11.8% using Govt. Transport. 5.9 % used Ambulance. 50% patients acknowledged of having advantage of referral note. Most of the patients (38.2%) were attended by Post Graduate Trainees, 29.4% were attended by Consultants and 23.5% patients were attended by Medical officer on duty. And among all the patients referred 20.6% of them were admitted while 79.4% of them received ambulatory services. Fisher’s Exact was applied to check association between referral note and its advantage. The two tailed P value equals 0.0149. The association between referral note and its Overall Advantage is considered to be statistically significant. Conclusions: The number of referrals to medical OPD of SHL is quite low which is attributed to more number of self referrals and unsatisfactory referral system. Even the patients being referred do not have prescribed referral form and most of the referrals were verbal. But level of consultancy is quite satisfactory for referred patients. Patients with referral note either prescribed or informal experienced advantage over verbally referred patients. Time delay to approach doctor after issuance of slip is not more than one hour for most of patients. Majority of referred patients are being attended by Senior doctors and in case being attended by House officers it is at least done under supervision of registrar. Most of the patients received OPD services and did not require admission and disposal is being decided by registrar or above Keywords: Referral Notes, Time Delay, Level of Consultancy.

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