Abstract

A referral is a process in which a health worker at a one level of the health system, having insufficient resources (drugs, equipment, skills) to manage a clinical condition, seeks the help of a better or differently resourced facility at the same or higher level to assist in (WHO). Referral system plays a vital role in management of diseases in any healthcare system. Typically, this system is pyramidal. Primary healthcare centers (PHC) constitute the base, which is large in numbers. Less number of secondary centers are in the middle, and a fewer number of tertiary care centers constitute the top. The PHC offer the minimum levels of essential tests and all basic treatments on an outpatient care basis, the secondary level centers are able to offer most of the diagnostic tests and management facilities, including hospitalization, interventional procedures, surgery, and rehabilitation programs. Tertiary level centers usually restricted for complex interventions and surgical procedures, prescription of high end costly tests. Secondary and tertiary level centers are also important for appropriate for training programs to strengthen our health care workforce. An effective referral system ensures a close relationship between all levels of the health system and helps to ensure people receive the best possible care closest to home. It also assists in making cost-effective use of hospitals and primary health care services. Support to health centers and outreach services by experienced staff from the hospital or district health office helps build capacity and enhance access to better quality care. In many developing countries, a high proportion of clients seen at the outpatient clinics at secondary facilities could be appropriately looked after at primary health care centers at lower overall cost to the client and the health system.

In this context, our objective is to do was to evaluate the current patterns of seeking prior care before arriving at a health center or a hospital as a key aspect of the referral system of the primary health care unit