Effective Factors in Improving the Family Physician Referral System in Bojnord, Iran

The healthcare referral system is one of the main factors for improving the health conditions, especially in developing countries. The present study aims to investigate the main factors for the improvement of the family physician referral system in Bojnord, Iran.

This is an analytical (quantitative-qualitative) survey that was conducted in 2021. In the qualitative phase, the related components were first extracted through interviews with a panel of experts (n=24). Then, a questionnaire was created based on the extracted items (n=30). In the quantitative phase, according to the experts’ opinions, the items were weighted using the fuzzy hierarchical analysis, where higher values indicate higher weight. The reliability of the questionnaire was evaluated using Cronbach’s α coefficient in SPSS software. Also, AHP software was used to perform the fuzzy hierarchy analysis.

Twenty components were identified by experts, which were divided into three categories including organizational/managerial requirements, human resources management requirements, and information technology requirements, with the weight values of 0.486, 0.213 and 0.301, respectively, indicating that organizational/managerial requirements were more important. Among the organizational/managerial requirements, the component of “design and implementation of service quality improvement cycles in the referral system” had the highest weight (0.159). Among the human resources management requirements, the component of empowering human resources had the highest weight (0.412). Among the information technology requirements, improvement of the information technology infrastructure had the highest weight (0.372).

The use of clear procedures and regulations, the digitalization of the referral system, and the staff training are among the very important factors that can lead to improving the referral system in Bojnord City.