Region wise referrals to a tertiary care centre: a retrospective analysis

Authors

  • Sirisha Paidi Department of Obstetrics and Gynecology, Andhra Medical College, King George Hospital, Visakhapatnam, Andhra Pradesh, India
  • Aashritha Thonangi Department of Obstetrics and Gynecology, Andhra Medical College/ King George Hospital, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20195201

Keywords:

Maternal morbidity and mortality, Maternal outcome, Obstetrics referrals

Abstract

Background: Emergency obstetric care in health care requires a linked referral system to be effective in reducing maternal morbidity and mortality. This review is aimed at summarizing the proportion of referrals from urban, rural and tribal areas of surrounding districts to tertiary care centre, King George Hospital, Visakhapatnam for a 6 month period; from May 2018 to October 2018.

Methods: Retrospective study done at a tertiary care teaching hospital, including 3157 cases referred from the surrounding urban, rural and tribal areas.

Results: Out of the 3157 referred cases, most of them (1658) were from rural areas, 1030 from urban and 469 from tribal areas. Referrals done in view of post caesarean pregnancies were more in urban and rural areas whereas more preeclampsia and anaemia cases were referred from tribal areas. Various indications of referral are documented. Majority of them were unbooked cases.

Conclusions: Specific guidelines regarding whom to refer, how to refer and when to refer would be helpful in making timely referral. These would also help to decrease the burden on the tertiary care centers which deal with a huge caseloads in spite of limited infrastructure and manpower. Adequate attention and better care can be given to complicated cases if the total case load is reduced. Stringent documentation in referral slip and better co-ordination are required for a strong health care system.

References

Park K. Textbook of Preventive and Social Medicine. 17th ed. Jabalpur. Banarasidas Bhanoj Publishers; 2000:632.

Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soci Sci Med. 1994;38:1091-110.

Brun JL, Billeaud C, Elleau C, Guyon F, Roux D, Dallay D, et al. Maternal transport to the Bordeaux University Hospital: a retrospective study of 263 cases (1996-1998). J Gynecol Obstet Biol Reprod. 2000;29(4):414-22.

Swain S, Prakash A. Utilisation of referral services by high risk pregnant population in rural Varanasi. Indian J Matem Child Health. 1992;3:74-6.

Koblinsky M, Chowdhury ME, Moran AC, Ronsmans C. Maternal morbidity and disability and their consequences: neglected agenda in maternal health. J Health Popul Nutr. 2012;30:124-30.

Lee AC, Lawn JE, Cousens S, Kumar V, Osrin D, Bhutta ZA, et al. Linking families and facilities for care at birth: what works to avert intrapartum related deaths? Int J Gynaecol Obstet. 2009;107(1):65-8.

Travis P, Bennett S, Haines A, Pang T, Bhutta Z, Hyder AA, et al. Overcoming health-systems constraints to achieve the millennium development goals. Lancet. 2004;364:900.

Paxton A, Bailey P, Lobis S. The United Nations process indicators for emergency obstetric care: reflections based on a decade of experience. Int J Gynaecol Obstet. 2006;95:192-208.

World Health Organization. Maternal Health and Safe Motherhood Programme‎. Mother-baby package: implementing safe motherhood in countries: practical guide. 1996. Available at: https://apps.who.int/iris/handle/10665/63268.

Puri A, Yadav I, Jain N. Maternal mortality in an urban tertiary care hospital of North India. J Obstet Gynaecol India. 2011;61(3):280-5.

Morsheda B, Shamsun N, Hashima EN. Assessing the MANOSHI referral system addressing delays in seeking emergency obstetric care in Dhaka’s Slums. MANOSHI working paper series Manoshi- WP10:1-36 published by ICDDR, B, BRAC; 2010:10.

Gupta PR, Chaudhary SN, Gonnade NV. Maternal and fetal outcome in referred patients to tertiary care center. Sch J App Med Sci. 2016;4(5C):1624-63.

Vinayak NM, Panditrao SK, Ramkrishna MA Critical study of referrals in obstetric emergencies. J Obstet Gynaecol India. 2004;54(3):258-9.

Patel HC, Singh BB, Moitra M, Kantharia SL. Obstetric referrals: scenario at a primary health centre in Gujarat. Natl J Community Med. 2012;3(4):711-4.

Khatoon A, Hasny SF, Irshad S, Ansari J. An audit of obstetrics referrals to Abbasi Shaheed Hospital. Pak J Surg. 2011;27(4):304-8.

Begum S, Aziz-un-Nisa I. Analysis of maternal mortality in a tertiary care hospital to determine causes and preventable factors. J Ayub Med Coll Abbottabad. 2003;15(2):49-52.

Downloads

Published

2019-11-26

Issue

Section

Original Research Articles