Referral pattern of patients received at the national referral hospital: challenges in low income countries

East Afr J Public Health. 2008 Apr;5(1):6-9. doi: 10.4314/eajph.v5i1.38969.


Objective: To examine the medical referral pattern of patients received at the Muhimbili National Hospital (MNH) in order to inform the process of strengthening the referral system.

Methods: The study design was a prospective study conducted at MNH during a 10-week study period from January to March 2004. The study sample consisted of patients referred to MNH.

Results: Of the 11,412 patients seen, 72.5% were self-referrals. More than 70% of the patients seen required admission, though not necessarily at tertiary level. Only 0.8% came from outside the Dar es Salaam region. More than 70% of the patients seen required admission. Surgical services were required by 66.8% of patients, with obstetric conditions being most prominent (24.6% of all patients). For those who were formally referred from other health services, lack of expertise and equipment were the most common reasons given for referral (96.3%).

Conclusion: Efforts to improve referral systems in low-income countries require that the primary and secondary level hospitals services be strengthened and increased so as to limit inappropriate use of national referral hospitals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Developing Countries
  • Female
  • Hospitals, Public
  • Hospitals, University
  • Humans
  • Income*
  • Male
  • Patient Acceptance of Health Care
  • Patient Admission*
  • Referral and Consultation*
  • Severity of Illness Index
  • Tanzania