Burden of Obstetrics and Gynaecological Referrals to Tertiary Health Care System

Article Information

Title: Burden of Obstetrics and Gynaecological Referrals to Tertiary Health Care System

Authors: Sarwat Memon, Amna Salman, Afshan Mumtaz, Mehnaz Memon

Journal: Journal of Gandhara Medical and Dental Sciences (JGMDS)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2022-07-01	2023-06-30
Y	2020-07-01	2021-06-30

Publisher: Gandhara University, Peshawar

Country: Pakistan

Year: 2023

Volume: 10

Issue: 1

Language: English

DOI: 10.37762/jgmds.10-1.391

Keywords: ObstetricsGynaecologyReferralsPattern.

Abstract

OBJECTIVES
This study aimed to assess the burden of obstetrics and gynaecological cases, causes and pattern of referral to tertiary care hospital.
METHODOLOGY
This descriptive cross-sectional study was carried out from May 2022-July 2022 using the data of patients who were referred to the Department of Obstetrics and Gynecology Unit 2 at Isra University Hospital from various primary, secondary, tertiary, and private hospitals for any obstetric or gynaecological emergency were the primary source of data. The confidentiality of each patient was carefully respected. This study evaluated the prevalence, reasons and pattern of referral of various obstetric and gynaecological conditions for which patients were referred to Isra University Hospital within the study duration and the management options provided to these patients.
RESULTS
The gynaecological cases accounted for the majority (71%) of referrals. Patients between 21-30 yrs of age comprised 51% of the total. Most patients (20%) were multipara in their third trimester (18%). High-risk patients (60%) were this study’s most common reason for referral, whereas financial restrictions (4%) were the least common. Only 5% of patients were referred from other tertiary care facilities, whereas 49% of patients came from the primary sector (49%), secondary (33%), and private (13%).
CONCLUSION
There is an imperative need to upgrade health system infrastructure, mainly primary and secondary health care systems and especially in the field of maternal and childcare, to enable prompt and appropriate diagnosis and management of various conditions in all nearby hospitals.

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Research Objective

To assess the burden of obstetrics and gynaecological cases, causes, and pattern of referral to a tertiary care hospital.

Methodology

A descriptive cross-sectional study conducted from May 2022 to July 2022 at Isra University Hospital. Data was collected from records of patients referred to the Department of Obstetrics and Gynecology Unit 2 from primary, secondary, tertiary, and private hospitals for obstetric or gynecological emergencies. Non-probability convenience sampling was used.

Methodology Flowchart

                        graph TD
    A["Data Collection from Referral Records"] --> B["Data Analysis using SPSS"];
    B --> C["Evaluation of Prevalence, Reasons, and Patterns"];
    C --> D["Formulation of Conclusions and Recommendations"];

Discussion

The study highlights a significant burden of gynaecological referrals to tertiary care, contrasting with some previous studies that reported a higher prevalence of obstetric referrals. The findings suggest a need to upgrade primary and secondary healthcare infrastructure, particularly in maternal and childcare, to improve prompt diagnosis and management. The high referral rate from primary and secondary sectors indicates a lack of adequate resources and specialists at these levels.

Key Findings

Gynaecological cases constituted the majority of referrals (71%). The most common age group referred was 21-30 years (51%). High-risk patients were the most common reason for referral (60%), while financial restrictions were the least common (4%). The majority of patients (49%) were referred from the primary sector.

Conclusion

There is an imperative need to upgrade health system infrastructure, especially primary and secondary healthcare systems in the field of maternal and childcare, to enable prompt and appropriate diagnosis and management of various conditions in all nearby hospitals.

Fact Check

1. Referral Period: The study was conducted over a three-month period from May 2022 to July 2022. (Confirmed)
2. Gynaecological vs. Obstetric Referrals: Gynaecological cases accounted for 71% of referrals, while obstetric cases accounted for 29%. (Confirmed)
3. Referral Source: 49% of patients were referred from the primary sector. (Confirmed)

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