Proportion, Appropriateness and Immediate Outcome of Referrals in Pediatric Ward at Bugando Medical Centre, Mwanza Tanzania (Record no. 18418)

MARC details
000 -LEADER
fixed length control field 03581nam a22003257a 4500
001 - CONTROL NUMBER
control field CUHAS/MMED/6000190/T/15
003 - CONTROL NUMBER IDENTIFIER
control field CUHAS/MMED/6000190/T/15
005 - DATE AND TIME OF LATEST TRANSACTION
control field 20240418122645.0
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 210821b |||||||| |||| 00| 0 eng d
028 ## - PUBLISHER OR DISTRIBUTOR NUMBER
Source Wurzburg Road 35, BMC Premises, Post Code: 33102:
Source P. O Box 1464, Mwanza – Tanzania:
Source Phone: +255 28 298 3384:
Source Fax: +255 28 298 3386:
Source Email: vc@bugando.ac.tz :
Source www.bugando.ac.tz
035 ## - SYSTEM CONTROL NUMBER
System control number CUHAS/MMED/6000190/T/15
040 ## - CATALOGING SOURCE
Transcribing agency ddc
041 ## - LANGUAGE CODE
Language code of text/sound track or separate title English
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Mwanahawa R. Suba
9 (RLIN) 22697
Dates associated with a name [Female]
Relator term CUHAS/MMED/6000190/T/15
245 ## - TITLE STATEMENT
Title Proportion, Appropriateness and Immediate Outcome of Referrals in Pediatric Ward at Bugando Medical Centre, Mwanza Tanzania
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Place of publication, distribution, etc. Mwanza, Tanzania:
Name of publisher, distributor, etc. Catholic University of Health and Allied Sciences [CUHAS - Bugando] :
Date of publication, distribution, etc. 2018
300 ## - PHYSICAL DESCRIPTION
Extent xiii; 61 Pages
Extent Includes References and Appendices
520 ## - SUMMARY, ETC.
Summary, etc. Abstract:<br/><br/>Background: Delayed referrals and inappropriate pre-referral care in primary health care facilities contribute to poor patients’ outcomes in secondary and tertiary referral health care facilities. This calls for a need to analyze the status of referrals seen at tertiary health care facility in order to come up with recommendations for patients care improvement at all levels of health care system.<br/><br/>Objective: To determine the proportion, appropriateness and immediate outcome of referrals in pediatric wards at Bugando Medical Centre (BMC).<br/>Methods: A hospital based cross sectional study enrolling all acutely referred children aged 1-59 months admitted in BMC pediatric wards. Referral forms were reviewed, detailed history and thorough physical examination were done. Children were viewed after 48 hours to determine the immediate outcome. Data were analyzed using STATA.<br/><br/>Results: A total of 300children were enrolled. Only 2% (6) had appropriately filled-in referral forms and only 3.3 (10) used ambulance as a means of transport. The proportion of referral was 55.1% (332/602), appropriateness was 16.7% (50), partially appropriate 39% (117) and inappropriate 44.3% (133). Death occurred in 34 (11.3%) [95% CI 8.2% - 15.5%]. In appropriate referrals were not associated with mortality at tertiary referral health care facilities. Other factors associated with mortality were, lower chest in drawing (OR: 4.9; 95% CI: 1.7 – 13.8; p=0.003), lower limb swelling (OR: 3.6; 95% CI: 1.3 – 10.2; p=0.013), convulsion (OR: 8.1; 95% CI: 2.2 – 29.9; p=0.008), shock (OR: 9.7 95% CI: 1.8 – 52.6; p=0.008), age>2 years (OR: 5.2; 95% CI: 1.7 – 16.2; p=0.004), and inability breastfeed or drink (OR: 7.3; 95% CI: 2.2 – 23.7; p=0.001).<br/><br/>Conclusion and recommendations: There is low proportion of referrals accompanied by large inappropriateness of referral. There is relatively low mortality which is linked to serious ill children (chest in drawing, convulsion, shock and inability to breastfeed or drink). The inappropriateness of referral is not associated with mortality. A clear guideline for referral is needed from the Ministry of Health to improve referral system along with improving their capacity of facilities at all levels. A specialized hospitals/clinics to refer children direct to tertiary hospitals to prevent unnecessary delay. <br/>
600 ## - SUBJECT ADDED ENTRY--PERSONAL NAME
General subdivision Pediatrics and Child Health
9 (RLIN) 48299
700 ## - ADDED ENTRY--PERSONAL NAME
9 (RLIN) 22795
9 (RLIN) 22832
9 (RLIN) 22050
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Source of classification or shelving scheme ddc
Koha item type POSTGRADUATE DISSERTATIONS
Holdings
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