Investigation of the chief complaint of patients referred to Tabriz AsadAbadi Hospital and its correspondence with the main causes of referral and final diagnosis

Abstract

For more than twelve years, a reform has been performedto the referral system in Iran, but its quality is still in question. One unclear case in this regard is the correspondence of the chief complaint, the primary diagnosis, and the final diagnosis of referral patients and the identification of the most important factors leading to referral, which was studied in this study. Method and materials:In this cross-sectional study carried out at AsadAbadi Hospital in Tabriz during the first four month of 1397 SH, information from 400 patients referring from urban and rural centers to AsadAbadi Hospital in terms of demographic variables, time and type of referral, features The referral centers, the frequency of patients of each referral center, the causes and method of referral, the chief complaint, the primary diagnosis and the final diagnosis and their correspondence, and the way in which the center's doctors were acted. Results:The mean age of referred patients was 39.7 ± 21.5 years, 68% were female and the mean age of women was significantly higher than males (p = 0.02). 94.5% of the patients did not have university education; among women, housework (81.2%) and among men (57%)self-employment was the most frequent job. 91.5% of the patients referred in the morning, 89.8% had no previous appointments and 73.3% took the visit in person. 55.5% of patients were from rural centers and the rest were referred from urban centers. Most frequent rural referral centers were Anakhaton, Espiran, Alvar-Sofla, and Mayan, and the most referring centers were BaniShafi, Jamshidabad and the Aid Committee. Internal medicine with 31.8%, followed by dermatology (11%), cardiology (9.5%) and psychiatry (9.5%) included the largest share of patient referrals. Also, the need for specialized assessment or practice (59%), referral physician introduction (48.8%), and referral to related specialty (88%) were identified as the most common cause of referral, selection of the AsadAbadi center and the selection of their physicians respectively. 79% of patients were referred to the center visited within the first three days after referral. High blood glucose (10.5%), abnormal tests (10%), skin lesions (9.7%) and behavioral disorders (7.7%) were the most common complaints of patients, and diabetes (12%), hypothyroidism (5.7%) and Hypertension (5%) was the most commonly diagnosed by physicians in AsadAbadi. In addition, in 74.3% medication was prescribed, 74.7% of the next referral date was given and 78.8% had feedback to the referral unit. Finally, the primary and final diagnosis of 60 patients out of 63 patients with primary diagnosis was consistent.