Evaluation of the referral system in Iran's rural family physician program; a study of Jiroft University of Medical Sciences

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