Alemu Tihtna, Yigzaw Zeamanuel Anteneh, Alemu Mekides Engeda, Asmare Lakew
Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Front Public Health. 2025 May 23;13:1434669. doi: 10.3389/fpubh.2025.1434669. eCollection 2025.
In resource-scarce countries such as Ethiopia, patients coming from primary care facilities directly to specialist hospitals pose an enormous challenge to the health system. This practice hinders continuity of care and reduces the quality of healthcare. However, little is known about the prevalence of self-referral in Ethiopia. Therefore, this study aimed to assess the self-referral practice and its associated factors in Northwest Comprehensive Specialized Hospital, Ethiopia.
A multi-center institutional-based cross-sectional design was conducted. A systematic random sampling technique was used to recruit a total of 446 participants. Structured interviewer-administered questionnaires were used. The collected data were entered into EpiData software and exported for analysis. Variables with a -value of <0.25 in the bi-variable analysis were considered candidates for multivariable analysis. A -value of <0.05 and a 95% confidence interval were used to determine the statistical association.
The prevalence of self-referral practice was 339 (70.40%). Thus, respondents who had an education level of college and above [AOR = 0.35, 95% CI = 0.10, 0.92], respondents who perceived their illness [AOR = 1.11, 95% CI = 1.06, 2.53], and those who had adequate knowledge about the referral system (AOR = 0.31, 95%CI = 0.16, 0.68) were significantly associated variables with self-referral practice.
According to this study's findings, more patients than expected visited specialized hospitals than previously reported. Various factors, such as educational level, perceived severity of illness, confidence in laboratory services, lack of information about referral methods, and limited use of primary care, contribute to this issue. Addressing these factors and strengthening the referral process are important steps to improve healthcare delivery, continuity of care, and patient satisfaction in Ethiopia.
在埃塞俄比亚等资源匮乏的国家，患者从基层医疗设施直接前往专科医院给卫生系统带来了巨大挑战。这种做法阻碍了连续护理，降低了医疗保健质量。然而，埃塞俄比亚自我转诊的患病率鲜为人知。因此，本研究旨在评估埃塞俄比亚西北综合专科医院的自我转诊做法及其相关因素。
采用多中心基于机构的横断面设计。使用系统随机抽样技术共招募了446名参与者。采用结构化访谈员管理的问卷。收集的数据录入EpiData软件并导出进行分析。双变量分析中P值<0.25的变量被视为多变量分析的候选变量。P值<0.05和95%置信区间用于确定统计关联。
自我转诊做法的患病率为339例（70.40%）。因此，大学及以上教育水平的受访者[AOR = 0.35，95%CI = 0.10，0.92]、认为自己患病的受访者[AOR = 1.11，95%CI = 1.06，2.53]以及对转诊系统有充分了解的受访者（AOR = 0.31，95%CI = 0.16，0.68）是与自我转诊做法显著相关的变量。
根据本研究的结果，前往专科医院就诊的患者比预期的多，高于先前报告的数量。教育水平、感知疾病的严重程度、对实验室服务的信心、缺乏转诊方法的信息以及基层医疗的使用有限等各种因素导致了这个问题。解决这些因素并加强转诊流程是提高埃塞俄比亚医疗服务提供、连续护理和患者满意度的重要步骤。
