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A network analysis of patient referrals in two district health systems in Tanzania

Francetic, I. and Tediosi, F. and Kuwawenaruwa, A.. (2021) A network analysis of patient referrals in two district health systems in Tanzania. Health Policy Plan, 36 (2). pp. 162-175.

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Abstract

Patient referral systems are fragile and overlooked components of the health system in Tanzania. Our study aims at exploring patient referral networks in two rural districts in Tanzania, Kilolo and Msalala. Firstly, we ask whether secondary-level facilities act as gatekeepers, mediating referrals from primary- to tertiary-level facilities. Secondly, we explore the facility and network-level determinants of patient referrals focusing on treatment of childhood illnesses and non-communicable diseases. We use data collected across all public health facilities in the districts in 2018. To study gatekeeping, we employ descriptive network analysis tools. To explore the determinants of referrals, we use exponential random graph models. In Kilolo, we find a disproportionate share of patients referred directly to the largest hospital due to geographical proximity. In Msalala, small and specialized secondary-level facilities seem to attract more patients. Overall, the results call for policies to increase referrals to secondary facilities avoiding expensive referrals to hospitals, improving timeliness of care and reducing travel-related financial burden for households.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Household Economics and Health Systems Research > Health Systems and Policy (Tediosi)
UniBasel Contributors:Francetic, Igor and Tediosi, Fabrizio and Shayo, Kuwawenaruwa August Joachim
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1460-2237 (Electronic)0268-1080 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:19 Dec 2022 14:59
Deposited On:19 Dec 2022 14:59

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