Original Research

The quality of feedback from outpatient departments at referral hospitals to the primary care providers in the Western Cape: a descriptive survey

Robert Mash, Herma Steyn, Muideen Bello, Klaus von Pressentin, Liezel Rossouw, Gavin Hendricks, Germarie Fouche, Dusica Stapar
South African Family Practice | Vol 61, No 6 : November/December| a5077 | DOI: https://doi.org/10.4102/safp.v61i6.5077 | © 2019 Robert Mash, Herma Steyn, Muideen Bello, Klaus von Pressentin, Liezel Rossouw, Gavin Hendricks, Germarie Fouche, Dusica Stapar | This work is licensed under CC Attribution 4.0
Submitted: 11 December 2019 | Published: 09 December 2019

About the author(s)

Robert Mash, Stellenbosch University, South Africa
Herma Steyn, Department of Health, Western Cape, South Africa
Muideen Bello, Stellenbosch University; Department of Health, Western Cape, South Africa
Klaus von Pressentin, Stellenbosch University; Department of Health, Western Cape, South Africa
Liezel Rossouw, Department of Health, Western Cape, South Africa
Gavin Hendricks, Stellenbosch University; Department of Health, Western Cape, South Africa
Germarie Fouche, Department of Health, Western Cape, South Africa
Dusica Stapar, Stellenbosch University; Department of Health, Western Cape, South Africa

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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.


Keywords

communication; coordination; primary health care/standards; physician–patient relations; referral; secondary care/standard

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