ArticleAfrican journal of primary health care & family medicine2025
Evaluating referrals between rural district hospitals and a regional hospital in South Africa.
Article in African journal of primary health care & family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Intubation exposure associated with first-pass success - understanding practitioner-related characteristics in South African EMS.International journal of emergency medicine · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEfficient referral systems are essential for improving healthcare and patient outcomes, especially in resource-limited settings where access to public specialist care is limited by too few specialists, growing populations and constrained resources impacting non-emergency and emergency referrals. District hospitals (DHs) must ensure that patients receive the appropriate level of care. High-quality referral systems are necessary for the cost-effective flow of patients between district and regional hospitals (RHs).
aimThis study aimed to evaluate emergency and non-emergency patient referral processes between DHs and the RH in two districts in South Africa.
settingTen DHs and the RH in the Garden Route and Central Karoo districts in South Africa.
methodsA mixed-methods design incorporated quantitative survey data and qualitative thematic analysis to provide a comprehensive understanding of referral processes. The study population included all doctors working at 10 DHs and the RH, with 120 voluntary participants.
resultsKey findings revealed disparities in referral satisfaction between emergency (66%) and non-emergency (59%) referrals. Communication breakdowns and systemic barriers hindered timely access to specialist care, mismatched expectations and understanding, coupled with inconsistent referral guidelines. Inadequate capacity building increased inappropriate referrals.
conclusionCommunication breakdowns and differing expectations between DHs and the RH regarding available resources and services negatively impacted referrals. Improved communication, targeted outreach, capacity-building initiatives, stronger collaborative relationships and standardisation of processes could enhance patient referral efficiency.Contribution: This work adds new knowledge to patient referrals between rural district and regional hospitals in resource-limited contexts, highlighting the complexity of the referral process.
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