Factors influencing upward referral system of patients in Nairobi County

Background: The referral system forms main health systems coordinating a mechanism ensuring the harmonious movement of patients between different levels care institutions for effective and efficient service delivery. study aimed at establishing determinants upward in Nairobi County. Methods: Cross-Sectional data collected from 204 respondents 2May to 30June, 2021, through structured questionnaire level 3-5 public facilities County was used. Data analyzed using SPSS. Doctors, nurses clinical officers who have referred previous three months were included while those had not excluded.Results: Bivariate analysis results revealed that knowledge (r=179*, p=0.011) complexity patient disease (r=097, p=0.170) positive significant correlation with system. Multivariate showed proximity facility statistical (β4=0.640, p<0.002) system.Conclusions: although healthcare workers know about strategy, they lack full comprehension strategy. Patients are mostly when higher diagnostic equipment needed medical conditions dire. recommends professional education equip human resources requisite on establishment communication lower or specialized ensure there smooth