Abstract
Aim : Objective: Our aim was to determine the referral pattern and characteristics of referred patients visiting military family medicine clinics in Tabuk, Saudi Arabia.
Methods: We performed a crosssectional study among patients who attended military family medicine clinics in Tabuk city during 2003. We selected ten percent of records of all attending patients through stratified systematic random sampling. Data concerning age, sex, diagnosis, referrals, follow up, health education, co-morbidities, and referral pattern were collected from patients' medical records using a pilot-tested data collection form. The extracted data were entered and analyzed using SPSS 17; statistical significance was set at a P value of < 0.05.
Results: There were 14,138 subjects analyzed; approximately 52% were male. Subject age ranged from less than one year to 98 years with a mean of 20.93 17.03 years. 11.7% (1,653) of subjects were referred to the military hospital, from family medicine clinics. Overall, female patients from the nearest clinics were significantly more frequently referred and referrals tended to increase with. The majority of the referrals were routine referrals (56%). Most subjects were referred to the surgical (37%), obstetrics/gynecological (30%), and internal medicine (16%) departments. Patients who were significantly more often referred to surgery, included subjects from the nearest clinics, males, those who received no health education, and those suffering from chronic morbidity. A significant number of referrals to internal medicine included female patients, older subjects, and patients with acute morbidity. Regression analysis showed age and location to be the only significant predictors of referral frequency. Feedback from specialists was received for approximately 13% of referrals, and was significantly higher for infants and patients with chronic co-morbidity.
Conclusion: Approximately 12% of patients were referred in Tabuk; most subjects were referred to surgical, obstetrics/gynecological, and internal medicine departments. Referrals to the surgical department were mostly to ophthalmology and ENT units, while internal medicine department referrals were mainly to dermatology and endocrinology units. Only about 13% of referrals received feedback letters from specialists in hospitals, which is an issue that should be addressed administratively and educationally in the undergraduate curriculum and post graduate residency programs for family medicine and other specialties