A network analysis of patient referrals in two district health systems in Tanzania
Bibliographic Data
| ID | 11490861 |
|---|---|
| Authors | Igor Francetic (0000-0002-2481-3749, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Socinstrasse 57, 4051 Basel, Switzerland, corresponding author), Fabrizio Tediosi (0000-0001-8671-9400, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Socinstrasse 57, 4051 Basel, Switzerland), August Kuwawenaruwa (0000-0001-8459-443X, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Socinstrasse 57, 4051 Basel, Switzerland) |
| Year | 2021 |
| Volume | 36 |
| Issue | 2 |
| Pages | 162-175 |
| Publication date | 2021-03-26 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy and Planning (JOURNAL) |
| Journal identifiers | ISSN: 0268-1080 • E-ISSN: 1460-2237 |
| Publisher | Oxford University Press (PUBLISHER • GB) |
| DOI | 10.1093/heapol/czaa138 |
| PMID | 33367559 |
| OpenAlex | W3115266106 |
| Language | EN |
| Citations received | 3 |
| References cited | 67 |
Patient referral systems are fragile and overlooked components of the health system in Tanzania. Our study aims at exploring patient referral networks in two rural districts in Tanzania, Kilolo and Msalala. Firstly, we ask whether secondary-level facilities act as gatekeepers, mediating referrals from primary- to tertiary-level facilities. Secondly, we explore the facility and network-level determinants of patient referrals focusing on treatment of childhood illnesses and non-communicable diseases. We use data collected across all public health facilities in the districts in 2018. To study gatekeeping, we employ descriptive network analysis tools. To explore the determinants of referrals, we use exponential random graph models. In Kilolo, we find a disproportionate share of patients referred directly to the largest hospital due to geographical proximity. In Msalala, small and specialized secondary-level facilities seem to attract more patients. Overall, the results call for policies to increase referrals to secondary facilities avoiding expensive referrals to hospitals, improving timeliness of care and reducing travel-related financial burden for households
Business · Descriptive statistics · Environmental health · Family medicine · Gatekeeping · Geography · Health facility · Health services · Medical emergency · Population · Public health · Referral · Tanzania · Global Maternal and Child Health · Healthcare Systems and Reforms · Healthcare Systems and Technology · Medicine · Nursing
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| Unique citing works | 3 |
|---|---|
| Citations per year | 0,75 |
| Citation span | 2022 - 2024 (3) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 2 |