Monitoring the referral system through benchmarking in rural Niger:: an evaluation of the functional relation between health centres and the district hospital
Monitoring the referral system through benchmarking in rural Niger:: an evaluation of the functional relation between health centres and the district hospital
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DOI：
10.1186/1472-6963-6-51
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发表时间：
2006-04-12
影响因子：
2.8
通讯作者：
Van Lerberghe, W
中科院分区：
文献类型：
--
作者：
Bossyns, P;Abache, R;Van Lerberghe, W
工作背景：本研究的主要目的是建立一个基准的转诊率在农村尼日尔，以便让常规转诊数据的解释，以评估性能的转诊系统在尼日尔。方法：严格和控制应用现有的临床决策树在农村卫生中心的样本允许估计相应的需要和特点的治疗转诊在农村尼日尔。还对转诊的依从性进行了监测。在11个农村地区，需求与实际转诊情况相匹配。转诊模式进行了登记，以便了解病理类型referenced.Results：转诊率基准设定为2.5%的病人咨询在卫生中心的治疗原因。尼日尔农村地区的转诊率还不到这一基准的一半。转诊的可接受性很低，这加剧了尼日尔转诊制度的不足。死亡率，因为转诊不足是最高的幼儿。结论：转诊模式表明，目前的方案提供保健的方法留下了大量的未满足的需求，只有全面的第一线和二线卫生服务可以提供一个适当的答案。另一方面，该基准表明，运作良好的保健中心可以解决病人面临的绝大多数问题。
Background: The main objective of this study is to establish a benchmark for referral rates in rural Niger so as to allow interpretation of routine referral data to assess the performance of the referral system in Niger.Methods: Strict and controlled application of existing clinical decision trees in a sample of rural health centres allowed the estimation of the corresponding need for and characteristics of curative referrals in rural Niger. Compliance of referral was monitored as well. Need was matched against actual referral in 11 rural districts. The referral patterns were registered so as to get an idea on the types of pathology referred.Results: The referral rate benchmark was set at 2.5 % of patients consulting at the health centre for curative reasons. Niger's rural districts have a referral rate of less than half this benchmark. Acceptability of referrals is low for the population and is adding to the deficient referral system in Niger. Mortality because of under-referral is highest among young children.Conclusion: Referral patterns show that the present programme approach to deliver health care leaves a large amount of unmet need for which only comprehensive first and second line health services can provide a proper answer. On the other hand, the benchmark suggests that well functioning health centres can take care of the vast majority of problems patients present with.