بررسی وضعیت ارجاع بیماران مراجعه کننده به بیمارستان های دانشگاه علوم پزشکی مازندران در سال 1377

Background and Purpose: Due to the frequent direct reference and unofficial admission of the patients in the Hospital which causes aver crowding of these Medical centers. Ând also would lead to inefficiency of foreseeing Medical services in the health and treatment network. Ïn order to determine the main reason of direct and unofficial referrals, this study was conducted on the patients referred to the hospital affiliated to Mazandaran Üniversity of Medical Sciences in 1998. Materials and Methods: This research was a descriptive one, done on 400 referred cases of who m 330 were non referrals and 70 cases were referrals. Variation was obsereved. Ôn the basis of the kind of referred cases, and were evaluatedon the kind of residential area (urban and rural), the level of awareness, the frequency of referrals and charges of medical services. Â questionnaire was filled at the place of admission by the questions or from the companion of the patients, and the data were collected. Results: This research showed that the majority of the referred patients (87.1%) were from the rural areas, and there was a significant relation between the resident of the patients with the kind of referral p=0. Âlso it was noticed that in the frequent references the willingness of the patients to the next reference was declined to . 90% of the referred patients were aware of the proper communication of the hospital with the health and treatment services centers, while such awareness was observed only in 35.6% of the non referred patients. Âlso most of the referred patients (77.1%) were those under the rural insurance organization of public medical services network. Çonclusion: Ïmplementation of proper management and supervision, in order to achieve efficient application of health services facilities and available treatment and its distribution on the basis of the requirement of different geographical regions is needed. Meanwhile giving information to public, specially on the comprehensive health services system of the country and the rule and the duty of each of the different units is very important. Denoting finance support of insurance companies or other organizations which share the medical expenses of puplic, play very important successive role on the referring system formalities.