TY - JOUR
T1 - Compliance with referral for curative care in rural Burkina Faso
AU - Pierre Ilboudo, Tegawende
AU - Chou, Yiing Jenq
AU - Huang, Nicole
PY - 2012/5
Y1 - 2012/5
N2 - Background The goal of this study is to contribute to improving the functioning of the referral system in rural Burkina Faso. The main objective is to ascertain the compliance rate for referral and to identify the factors associated with successful referral.Methods A record review of 12 months of curative consultations in eight randomly selected health centres was conducted to identify referral cases. To assess referral compliance, all patient documents at referral hospitals from the day of the referral up to 7 days later were checked to verify whether the referred case arrived or not. Descriptive statistics were then used to compute the compliance rate. Hierarchical modelling was performed to identify patient and provider factors associated with referral compliance.Results The number of visits per person per year was 0.6 and the referral rate was 2.0. The compliance rate was 41.5 (364/878). After adjustment, females (OR=0.71; 95 CI=0.52-0.98), patients referred during the rainy seasons (OR=0.56; 95 CI=0.40-0.78), non-emergency referrals (OR=0.47; 95 CI=0.34-0.65) and referrals without a referral slip (OR=0.30; 95 CI=0.21-0.43) were significantly less likely to comply. Children between 5 and 14 years old (OR=0.61; 95 CI=0.35-1.06) were at a higher risk of non-compliance, but the difference did not reach statistical significance. Moreover, none of provider characteristics was statistically significantly associated with non-compliance.Conclusions In a rural district of Burkina Faso, we found a relatively low compliance with referral after the official referral system was organized in 2006. Patient characteristics were significantly associated with a failure to comply. Interventions addressing female patients' concerns, increasing referral compliance in non-emergency situations, reducing inconvenience and opportunity costs due to seasonal/climate factors, and assuring the issue of a referral slip when a referral is prescribed may effectively improve referral compliance.
AB - Background The goal of this study is to contribute to improving the functioning of the referral system in rural Burkina Faso. The main objective is to ascertain the compliance rate for referral and to identify the factors associated with successful referral.Methods A record review of 12 months of curative consultations in eight randomly selected health centres was conducted to identify referral cases. To assess referral compliance, all patient documents at referral hospitals from the day of the referral up to 7 days later were checked to verify whether the referred case arrived or not. Descriptive statistics were then used to compute the compliance rate. Hierarchical modelling was performed to identify patient and provider factors associated with referral compliance.Results The number of visits per person per year was 0.6 and the referral rate was 2.0. The compliance rate was 41.5 (364/878). After adjustment, females (OR=0.71; 95 CI=0.52-0.98), patients referred during the rainy seasons (OR=0.56; 95 CI=0.40-0.78), non-emergency referrals (OR=0.47; 95 CI=0.34-0.65) and referrals without a referral slip (OR=0.30; 95 CI=0.21-0.43) were significantly less likely to comply. Children between 5 and 14 years old (OR=0.61; 95 CI=0.35-1.06) were at a higher risk of non-compliance, but the difference did not reach statistical significance. Moreover, none of provider characteristics was statistically significantly associated with non-compliance.Conclusions In a rural district of Burkina Faso, we found a relatively low compliance with referral after the official referral system was organized in 2006. Patient characteristics were significantly associated with a failure to comply. Interventions addressing female patients' concerns, increasing referral compliance in non-emergency situations, reducing inconvenience and opportunity costs due to seasonal/climate factors, and assuring the issue of a referral slip when a referral is prescribed may effectively improve referral compliance.
KW - Burkina Faso
KW - compliance
KW - District health system
KW - referral
UR - http://www.scopus.com/inward/record.url?scp=84860116123&partnerID=8YFLogxK
U2 - 10.1093/heapol/czr041
DO - 10.1093/heapol/czr041
M3 - Review article
C2 - 21613247
AN - SCOPUS:84860116123
SN - 0268-1080
VL - 27
SP - 256
EP - 264
JO - Health Policy and Planning
JF - Health Policy and Planning
IS - 3
ER -