Abstract:

Background: Prostate cancer is a significant health issue in Mwanza City, Tanzania, with many patients arriving at Bugando Medical Centre (BMC) in advanced stages. This late presentation limits treatment options and overall outcomes. Understanding the factors leading to delayed referrals is crucial for improving early detection and care. This study explored the prevalence and factors associated with denied patient-initiated referrals among prostate cancer patients at BMC.

Methods: A cross-sectional study was conducted over two months, involving prostate cancer patients with referral letters from other healthcare facilities. Data were collected using structured questionnaires that covered sociodemographic information and details about referral attempts. The sample size was calculated using the Taro Yamane formula, resulting in a sample of 99. Convenience sampling was used to select participants based on availability and willingness. Data were analyzed using SPSS version 20, employing descriptive statistics to calculate prevalence rates and inferential statistics, including chi-square and t-tests, to examine associations between variables and referral outcomes.

Results: The majority of referrals (87.8%) came from regional hospitals, and 61.2% were initiated by healthcare providers. Among those who attempted self-referral, 26.5% requested a referral, but 84.6% of these requests were denied. Main reasons for denial included lack of medical necessity (63.9%) and unmet referral criteria (13.6%).

Conclusion: High denial rates for patient-initiated referrals highlight barriers to timely care. Addressing these issues could improve early access and patient outcomes.