Volume 19, Issue 2 (9-2021)
sjsph 2021, 19(2): 157-172 |
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Kabir M J, Haydari A, Honarvar M R, Khatirnameni Z, Badakhshan A, Rafiei N, et al . Executive Challenges of Electronic Referral System in the Health Centers and Hospitals in Golestan Province, Iran: A Qualitative Study. sjsph 2021; 19 (2) :157-172
URL: http://sjsph.tums.ac.ir/article-1-6023-en.html
URL: http://sjsph.tums.ac.ir/article-1-6023-en.html
Mohammad Javad Kabir1 
, Alireza Haydari * 2, Mohammad Reza Honarvar3 , Zahra Khatirnameni4 , Abbas Badakhshan3 , Narges Rafiei5 , Sakine Beygom Kazemi5 , Seyed Mehdi Sedaghat6 , Mehrdad Kamangari6 , Masoumeh Gholami5 , Maryam Eri4 , Mansoureh Lotfi4
, Alireza Haydari * 2, Mohammad Reza Honarvar3 , Zahra Khatirnameni4 , Abbas Badakhshan3 , Narges Rafiei5 , Sakine Beygom Kazemi5 , Seyed Mehdi Sedaghat6 , Mehrdad Kamangari6 , Masoumeh Gholami5 , Maryam Eri4 , Mansoureh Lotfi4
1- Ph.D. Associated Professor, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
2- Ph.D. Assistant Professor, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran ,alirezaheidari7@gmail.com
3- Ph.D. Assistant Professor, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
4- Msc. Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
5- Ph.D. Candidate in Health Services Management, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
6- MD. Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
2- Ph.D. Assistant Professor, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran ,
3- Ph.D. Assistant Professor, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
4- Msc. Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
5- Ph.D. Candidate in Health Services Management, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
6- MD. Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
Abstract: (2081 Views)
Background and Aim: The World Health Organization considers the implementation of the referral system to be a key step in improving the quality of services in health care systems. The purpose of this study was to explain the executive challenges of the electronic referral system in Golestan Province, Iran.
Materials and Methods: A qualitative study was conducted in Golestan Province, Iran in 2019 with a content analysis approach. The participants were family physicians, specialists, university staff managers, responsible health officers in the Offices of Deputy Ministers of Health, the General Directorate of Health Insurance, Department of Information Technology, Rural Health Network managers, health network managers and patients selected purposefully. Data were collected through semi-structured interviews and analyzed using the content analysis method.
Results: The main challenges of giving appointments to patients included the lack of time of family physicians, the irregular presence of specialists, difficulty in getting an appointment, and reverse referrals. As regards referrals and waiting times, the main challenges were found to be the lack of sufficient admissions following cancellation of the health insurance contract with the private sector, the delay of physicians in attending the health centers, long waiting times to be visited, and writing the feedback by the physicians. In addition, the main challenges of the visits and diagnosis included the short visiting times, the higher quality of the specialists' visits in the private sector, and the lack of clear guidelines. Finally, the main challenges as regards giving feedback were the reluctance and noncommitment of some specialists to provide feedback, as well as the low quality and lack of usability of the feedbacks given.
Conclusion: Based on the findings of this study, the following actions and measures may help improve the current situation as regards the current referral systems: allocating sustainable resources; allocating financial credits; designing and implementing a reward and punishment system; reforming the queuing system; empowering medical students; and equipping specialists with electronic pens for giving written feedback.
Materials and Methods: A qualitative study was conducted in Golestan Province, Iran in 2019 with a content analysis approach. The participants were family physicians, specialists, university staff managers, responsible health officers in the Offices of Deputy Ministers of Health, the General Directorate of Health Insurance, Department of Information Technology, Rural Health Network managers, health network managers and patients selected purposefully. Data were collected through semi-structured interviews and analyzed using the content analysis method.
Results: The main challenges of giving appointments to patients included the lack of time of family physicians, the irregular presence of specialists, difficulty in getting an appointment, and reverse referrals. As regards referrals and waiting times, the main challenges were found to be the lack of sufficient admissions following cancellation of the health insurance contract with the private sector, the delay of physicians in attending the health centers, long waiting times to be visited, and writing the feedback by the physicians. In addition, the main challenges of the visits and diagnosis included the short visiting times, the higher quality of the specialists' visits in the private sector, and the lack of clear guidelines. Finally, the main challenges as regards giving feedback were the reluctance and noncommitment of some specialists to provide feedback, as well as the low quality and lack of usability of the feedbacks given.
Conclusion: Based on the findings of this study, the following actions and measures may help improve the current situation as regards the current referral systems: allocating sustainable resources; allocating financial credits; designing and implementing a reward and punishment system; reforming the queuing system; empowering medical students; and equipping specialists with electronic pens for giving written feedback.
Keywords: Executive Challenge, Electronic Referral System, Golestan Province, Family Hysicians, Referral System, Qualitative Study
Type of Study: Research |
Subject:
Public Health
Received: 2021/11/1 | Accepted: 2021/09/22 | Published: 2021/09/22
Received: 2021/11/1 | Accepted: 2021/09/22 | Published: 2021/09/22
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