Abstract
Background: Coordinating care for patients is a key characteristic of effective primary care. Family physicians in the Western Cape formed a research network to enable them to perform practical research on key questions from clinical practice. The initial question selected by the network focused on evaluating the quality of referrals to and feedback from outpatient departments at referral hospitals to primary care providers in the Western Cape.Methods: A descriptive survey combined quantitative data collected from the medical records with quantitative and qualitative data collected from the patients by questionnaire. Family physicians collected data on consecutive patients who had attended outpatient appointments in the last three months. Data were analysed using the Statistical Package for the Social Sciences.Results: Seven family physicians submitted data on 141 patients (41% male, 59% female; 46% metropolitan, 54% rural). Referrals were to district (18%), regional (28%) and tertiary hospitals (51%). Referral letters were predominantly biomedical. Written feedback was available in 39% of patients. In 32% of patients, doctors spent time obtaining feedback; the patient was the main source of information in 53% of cases, although many patients did not know what the hospital doctor thought was wrong (36%). The quality of referrals differed significantly by district and type of practitioner, while feedback differed significantly by level of hospital.Conclusion: Primary care providers did not obtain reliable feedback on specialist consultations at referral hospital outpatients. Attention must be given to barriers to care as well as communication, coordination and relationships across the primary–secondary interface.
Highlights
High-quality primary care is characterised by accessibility, continuity, comprehensiveness, coordination and patient-centredness.[1]
The Vula app enables primary care providers to contact the specialist on call, provide patient information and receive feedback on a patient that they would like to refer as an emergency, but is not intended for outpatient referrals
Primary care facilities with their primary care providers that are supported by family physicians within Stellenbosch University Family Physician Research Network (SUFPREN) participated in the study
Summary
High-quality primary care is characterised by accessibility, continuity, comprehensiveness, coordination and patient-centredness.[1]. Many patients are handled with advice from the specialist, while others can be quickly accepted for referral Another system (eCCR—Electronic Continuity of Care Record) is enabling electronic in-patient discharge summaries to be created and accessed across the platform. The single patient viewer system is trying to link patients’ electronic information across levels of care by using a unique identifier None of these initiatives, address the quality of referrals and feedback from outpatient visits. The initial question selected by the network focused on evaluating the quality of referrals to and feedback from outpatient departments at referral hospitals to primary care providers in the Western Cape. Conclusion: Primary care providers did not obtain reliable feedback on specialist consultations at referral hospital outpatients. Attention must be given to barriers to care as well as communication, coordination and relationships across the primary– secondary interface
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