published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Family practice physicians receive many non-emergency after-hours phone calls. Patients themselves could care for non-emergencies until their doctor is in his office. The purpose of this study is the development and testing of a patient information booklet to provide patient education for non-emergency self care. The booklet will hopefully result in better home health care and a reduction of non-emergency after-hours phone calls. The booklet could be a valuable asset for the family physician for both patient education and the reduction of physician occupational dissatisfaction.This booklet will also provide information about the Ball Memorial Hospital Family Practice Center and the specialty of Family Practice. This study will suggest a method to determine if such a booklet actually reduces the number of non-emergency after-hours phone calls received by residents of the Family Practice Center.Ball State UniversityMuncie, IN 47306

Thesis (M. Cur.) --University of Limpopo, 2015 / The purpose of this study was to determine the factors that were contributing to selfreferrals of antenatal women at the Dilokong Hospital in the Tubatse Local Municipality. By employing a quantitative, non-experimental research method, 360 women completed and submitted a structured questionnaire. Validity and reliability were insured by pre-testing the data collection instrument on respondents who were not part of the main study. Data was analysed by using the SPSS and Excel computer programs with the assistance of a statistician. The age group between 21 and 30 years 197 (54.7%) was larger than the other age groups. Primigravida women represented less than half 147 (40.3%) of the respondents. These women were also supposed to be referred to the hospital for delivery; however, only 23.3% of the women were referred to the hospital for delivery. The choice of the delivery site was influenced by a lack of women’s knowledge about the referral system and of services offered at the clinics, as well as the unavailability of doctors, midwives, food, equipment, enough space for delivery at the clinics, and the perceptions that nurses and midwives were rude. The government should ensure that the clinics are provided with adequate human resources and other resources that are needed for providing these health services. Pregnant women should be given referral letters and information with regard to where they are supposed to deliver. Key concepts: Antenatal women, self-referral, referral system, and Primary Health Care (PHC).

Source: Masters Abstracts International, Volume: 47-06, page: 3552. Adviser: T. Robert Harris. Includes bibliographical references.

This prospective descriptive study describes the referral patterns to the Red Cross War Memorial Children's Hospital. The study was conducted from 1st July to 31st December 1987 and entailed the collection of all referral letters presented (9288) to the hospital and the analysis of a sample of these letters (4702). The results indicated: * The patients are similar in terms of age and sex to those attending the Outpatients Department except that relatively fewer referred patients are Black. * The private sector, i.e. general practitioners, is the largest referral agency followed by Day Hospitals. * Most patients were ref erred to the Outpatients Department without an appointment. * Of the specialist clinics, the surgical clinics, i.e. Ophthalmology and Ear, Nose and Throat Clinics, were utilised the most. * The majority of patients (84,90%) were not admitted. * The contact made by the hospital with referral agents was poor (only in 30,30%). * The quality of information in referral letters was generally poor and did not contribute to patient care. Recommendations are made to the hospital and relevant health authorities.

Research has shown that children born low birth weight (i.e., ≤2500 grams) and/or premature (i.e., birth prior to 37 weeks gestation) are at increased risk of experiencing developmental delays, as well as long-standing executive functioning and academic challenges. Despite these well-known risks, children born low birth weight are under-enrolled nationally in Part C Early Intervention (EI) services intended to support developmentally vulnerable children. Little is known regarding why EI enrollment is low in this high risk population, especially given children born LBW are readily identifiable as at increased risk of delays at birth. This study explored EI referral outcomes from a high risk infant follow up program serving children with complex early medical histories that place them at increased risk of experiencing developmental delays to determine how many children referred to EI were ultimately evaluated and enrolled in the program. This explanatory sequential mixed methods study included a quantitative phase characterizing the EI referral outcome and a qualitative phase consisting of interviews with families to explore the parent/caregiver's experience of the EI referral process. Data analysis included descriptive statistics to characterize the sample and Pearson Chi Square and independent samples t-tests to investigate child characteristics associated with successful referral. Qualitative interviews were transcribed and coded for themes in an iterative and cyclical fashion. Results indicate that only 62% of the children who were referred for EI services were evaluated by the program, with about the same percentage of those evaluated being found eligible (67%). Of those who were not found eligible, about a third of children should have qualified based on previous testing and/or medical conditions. However, these qualifying medical conditions were often not clearly documented on the referral form, and not all forms included documentation of the scores from developmental testing. There were also a significant number (71%) of Oregon children referred to EI but never evaluated who were likely to have qualified based on medical history and/or results from developmental testing. There were several key themes identified following analysis of the qualitative interviews. Most critically, the parent/caregiver's perception of the need for the EI referral was identified as an essential factor in facilitating a successful connection to EI. Other key themes included the need to honor the many different demands placed on the caregivers of these high risk children, as well as the necessity of providing clear explanation of the purpose of both the visit to the high risk infant follow up program and the EI referral. The Chronic Care Model is used as a framework for discussing implications for practice.

Thesis (M.Phil.)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: The aim of this research is to identify the various levels of health care units, their relationships and the problems hindering an effective referral system. To achieve this goal, use is made of a case study of the West Rand area in Gauteng. The standpoint is that, to achieve Primary Health for all South Africans referral systems within health care units and levels must be reciprocal. It is argued that for Primary Health Care to be successful, it must satisfy the goal of affordability appropriateness and accessibility. Results from the research revealed that four health care levels, namely traditional healers, health NGOs, Clinics, and Hospitals. Though there is some degree of referral in the study area, it was observed that referrals in the study area were not reciprocal. Amongst the major problems identified as hindering an effective referral system in the study area, include lack of cooperation between health institutions, poor health infrastructure and communication network as well as lack of other health paraphernalia. The research also found that government policy towards some of the health institutions (Traditional healers) contributes to the inefficiency of proper referrals in the study area. / AFRIKAANSE OPSOMMING: Die oogmerk van hierdie ondersoek is om die verskillende vlakke van gesondheidsorgeenhede, hulonderlinge verbande en die probleme wat doeltreffende verwysings in die wiele ry, te identifiseer. Dit word gedoen aan die hand van 'n gevallestudie van die Wes-Randarea in Gauteng. Die uitgangspunt is dat doeltreffende Primêre Gesondheid vir alle Suid- Afrikaners afhang van resiprokale verwysingsisteme tussen gesondheidsorgeenhede en -vlakke. Suksesvolle Primêre Gesondheidsorg vereis bekostigbaarheid, toepaslikheid en toeganklikheid. Die ondersoek het vier gesondheidsorgvlakke aan die lig gebring: tradisionele genesers, gesondheids-nie-regerings-organisasies, klinieke en hospitale. Hoewel daar 'n mate van onderfinge verwysing in die studie-area bestaan, was dit nie wederkerig nie. Onder die vernaamste struikelblokke vir 'n doeltreffende verwysingsisteem tel swak samewerking tussen gesondheidsinstellings, gebrekkige gesondheidsinfrastruktuur en kommunikasienetwerk, en 'n skaarste aan ander gesondheidsmiddelle. Die ondersoek het ook bevind dat regeringsbeleid aangaande sommige van die gesondheidsinstellings (tradisionele genesers) bydra tot die ondoeltreffendheid van verwysings in die studie-area.

The purpose of this project is to support health promotion of children entering foster care, ensure that children receive all health care services needed, prevent the trauma of duplication of immunizations, and reduce disruption of health care as children move through the foster care system.

Thesis (M. (Nursing)) -- University of Limpopo, 2022 / Background: The referral system is an essential component of the health system. The system meant to complement the Primary Health Care (PHC) principle of treating patients close to their homes at the lowest level of care with the needed expertise. Aim of the study: The aim of the study is to develop the strategies that will facilitate the referral system of high-risk pregnant women in between public sectors in the Bojanala district, North West Province, South Africa. Objectives of the study: To explore the referral system of high-risk pregnant women between public sectors within the Bojanala District, North West Province, South Africa. To develop strategies that will facilitate the referral system of high risk pregnant women in the Bojanala District, North West Province, South Africa. Methods: The researcher first obtained permission from the University of Limpopo Turfloop Research Ethics Committee (TREC), and further requested permission from the North West Department of Health, Bojanala District to conduct the study and was granted the permission. Qualitative, exploratory and descriptive designs were used to explore the referral system of high-risk pregnant women and to describe the strategies to facilitate the referral system of high-risk pregnant women in between public sectors in the Bojanala District, North West, South Africa. Non-Probability Purposive sampling method was used to select the midwives and obstetricians to participate in the study until data saturation was reached. Data were collected through one-on-one interviews using semi structured Interview Guide. The data were analysed using Tesch‘s eight steps of data analysis. Results: The results of this study revealed that the participants are knowledgeable about the referral system though they are many challenges that they encounter when managing high-risk women and having to refer them. They are aware of the current state of referral system and made their own suggestions on how to improve the referral system. Recommendations: Recommendations were made to facilitate the referral system of high-risk pregnant women in the North West Province, Bojanala District. The Department of Health must prioritise the provision of human and material resources to the district in order to achieve a better referral system and reducing the maternal and neonatal mortality as one of the millennium developmental goals. Conclusion: The referral system of high-risk pregnant women in the Bojanala District still has some challenges that need the intervention of the North West Department of Health to provide enough material and human resources to the Maternity Section in order to improve current status and to have an effective referral system

In the last decade, the deployment of Electronic Health Records has increased tremendously in many developed countries. This increasing trend intensifies the need for developing countries like South Africa to implement electronic health record systems in state owned hospitals to facilitate e-referral processes to improve health care delivery. The aim of this research was to investigate the current process of patient record keeping, management, and the referral process of patients within the same hospital and to other hospitals and based on the findings compile an Electronic Health Record (EHR) framework to facilitate e- referral processes. This research study was based on a qualitative case study approach. A multiple data collection technique was used which included group interviews, questionnaires, document analysis and informal discussions with the hospital workers. Data were analysed by categorization and thematic approach. The findings obtained from state hospitals indicated that there is no EHR system which accommodates patient health record systems to facilitate e-referral processes. These findings led to a compilation of the Limpopo Electronic Health Record System (LEHRS) to aid e-referral processes in state hospitals. The increasing need for accurate, reliable, available and accessible EHR will be addressed by the implementation of LEHRS as information will be stored in a central database in a useable format and will be easily accessed. / Computing / M. Tech. (Information Technology)