bioRxiv Science⌕ Search
Home/Archive/bioRxiv

bioRxiv · 10.1101/540476

Determinants of Self-referral among Outpatients at Referral Hospitals in East Wollega, Western Ethiopia

Geta, E. T.·Belete, Y. S.·Yesuf, E. A.
View original source ↗Export metadata ↓

Abstract

BackgroundPatient self-referral is a condition when patients refer themselves to higher level health facilities without having to see anyone else first or without being told to refer themselves by health professional. Despite the expansion in the number of health facilities, it has been seen when patients routinely accessed referral hospitals. The study aims to determine the magnitude and identify determinants of outpatient self-referral at referral hospitals. MethodsFacility based cross sectional study design was used to collect data from December 01- 30; 2017.The sample size was determined by using single population proportion formula. Data entry and analysis were made using SPSS version 20. Descriptive statistics of frequency, bivariate and multivariate logistic regression were performed. ResultsA total of 404 outpatients were included making response rate 96.8%. Among 391 outpatients interviewed 330(84.4%) were self-referred. The factors significantly associated with outpatient self-referral were referral information (AOR and 95%CI=0.324(0.150-0.696), illness severity (AOR and 95% CI=3.496(1.473-8.297), confidence of patients to get providers (AOR and 95 CI=3.027(1.510-6.070), availability of laboratory (AOR and 95%CI=4.966(2.199-11.216) and drugs (AOR and 95%CI=2.366(1.013-5.526) and quality of services (AOR and 95%CI=2.996(1.418-6.328). ConclusionThe proportion of outpatients self-referral was high and that associated with referral information, patient confidence to get health care providers, severity of illness, availability of laboratory and drugs, and quality of services. There should be monitoring system of referral linkage of health facilities at all levels and the health facilities should create awareness in the community about referral linkages of health facilities.

Source connections

Explore related subjects

epidemiologyPreprint

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Geta, E. T., Belete, Y. S., Yesuf, E. A.. 2019-02-05. Determinants of Self-referral among Outpatients at Referral Hospitals in East Wollega, Western Ethiopia. https://doi.org/10.1101/540476

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related preprints

bioRxiv2019

The Relationship between Body Mass Index and Poor Self-Rated Health in the Korean Population

ObjectiveSeveral previous studies have evaluated associations between body mass index (BMI) and self-rated health (SRH); however, the results were inconsistent. This study aimed to examine the association between BMI and SRH in Korean adults.\n\nMethodsThe study was conducted in 214,997 adults who participated in the 2016 Korean Community Health Survey. Participants were categorized into four groups based on BMI: underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), or obese ([&ge;]30.0 kg/m2). Multivariate Poisson regression analysis with sampling weights and robust variance estimators was performed to evaluate the relationship between BMI categories and poor SRH.\n\nResultsThere was a J-shaped association between BMI and poor SRH in both sexes, with the lowest risk observed in the normal weight group in both sexes. Compared with normal weight subjects, the age and lifestyle adjusted prevalence rate ratios for poor SRH were 1.61 (95% CI, 1.50-1.74) for underweight, 1.16 (95% CI, 1.11-1.21) for overweight, and 2.35 (95% CI, 2.13-2.58) for obese men; and 1.24 (95% CI, 1.17-1.32) for underweight, 1.26 (95% CI, 1.22-1.31) for overweight, and 1.77 (95% CI, 1.64-1.91) for obese women.\n\nConclusionsIn a cross-sectional study using a nationally representative survey, there was a nonlinear relationship between BMI and poor SRH. This relationship was more prominent in men than in women. Prospective studies are needed to further clarify the relationship between BMI and SRH.

epidemiology↗
bioRxiv2019

Seroprevalence of human Brucellosis and associated risk factors among high risk occupations in Mbeya Region of Tanzania

BackgroundBrucellosis is an infectious zoonotic disease that affects humans, livestock and wildlife.\n\nMethodsA cross-sectional study was conducted in Mbeya region between November 2015 and January 2016 to investigate the seroprevalence of human brucellosis and identify associated risk factors among individuals in risky occupations in Mbeya Region. A total of 425 humans from six occupational categories were serially tested for Brucella antibodies using the Rose Bengal Plate Test (RBPT) and competitive Enzyme Linked Immunosorbent Assay (c-ELISA), for screening and confirmation, respectively. A questionnaire survey was administered to participants collect epidemiological data.\n\nResultsThe overall seroprevalence among the high risk occupational individuals was 1.41% (95% CI: 0.01-0.03). Seroprevalence among the different occupations were as follows: shepherds 1.33% (95% CI: 0.14-0.22); butcher men 5.26% (95% CI: 0.10-0.17) and abattoir workers 1.08% (95% CI: 0.39-0.49). Seroprevalence was noted to vary according to occupation type, milk consumption behaviour, age and sex. Butcher men recorded the highest seroprevalence (5.0%) while individuals who consumed unboiled milk had a higher seroprevalence (1.56%) compared to those who drunk boiled milk. High seropositivity (2.25%) was observed among the age group of 1-10 years while male individuals had a higher seroprevalence (1.41%) than females (0%). Butcher men were at higher risk of exposure compared to other professions.\n\nConclusionOur findings show the presence of brucellosis in occupationally exposed individuals in Mbeya region. There is need to sensitize the exposed individuals in order to reduce the risk of acquiring Brucella infections from animals and animal products This also calls for public health awareness about the disease, and implementation of control measures that will prevent further spread of brucellosis within and outside the study area..\n\nAuthor summaryBrucellosis is a bacterial zoonosis that has evolved to establish itself as an occupational and food-borne disease Worldwide. It is responsible for huge economic losses incurred by livestock keepers and poses a public health risk to humans in most developing countries. In Tanzania, which has the 3rd highest cattle population in Africa, many studies that have been done show that brucellosis exists in livestock, especially in cattle and wildlife. However, very few studies have reported on human brucellosis. The disease has been reported to occur in humans who have direct exposure to cattle or cattle products like livestock farmers, abattoir workers, veterinarians, shepherds and farm workers in many developing countries. A few studies in Tanzania have reported seroprevalences among these high-risk occupations; however, the disease has not been fully described in Mbeya region. This study was therefore aimed at filling these information gaps and contributing to the existing body of knowledge.

epidemiology↗
bioRxiv2019

Development of equations for converting random-zero to automated oscillometric blood pressure values

ObjectiveThis study aimed to collect data to compare blood pressure values between random-zero sphygmomanometers and automated oscillometric devices and generate equations to convert blood pressure values from one device to the other.\n\nMethodsOmron HEM-907, a widely used automated oscillometric device in many epidemiologic surveys and cohort studies, was compared here with random-zero sphygmomanometers. Two hundred and one participants aged 40-79 years (37% men) were enrolled and randomly assigned to one of two groups with blood pressure measurement first taken by automated oscillometric devices or by random-zero sphygmomanometers. The study design enabled comparisons of blood pressure values between random-zero sphygmomanometers and two modes of this automated oscillometric device - automated and manual, and assessment of effects of measurement order on blood pressure values.\n\nResultsAmong all participants, mean blood pressure levels were lowest when measured with random-zero sphygmomanometers compared with both modes of automated oscillometric devices. Several variables, including age and gender, were found to contribute to the blood pressure differences between random-zero sphygmomanometers and automated oscillometric devices. Equations were developed using multiple linear regression after taking those variables into account to convert blood pressure values by random-zero sphygmomanometers to automated oscillometric devices.\n\nConclusionEquations developed in this study could be used to compare blood pressure values between epidemiologic and clinical studies or identify shift of blood pressure distribution over time using different devices for blood pressure measurements.

epidemiology↗