The Status of the Referral System in the Family Physician Program in Isfahan Metropolitan Area: a Qualitative Study

Primary levels of health services are designed to provide, maintain and promote the health of healthy young people, while the goal of higher levels is to screen and restore the health of the patients. One of the challenges is the personal culture of some of the health service providers and the recipients of these services. One of the recent reforms in the healthcare system has been the implementation the Health System Reform Plan based on the family physician and the referral system. This study investigated the status of the referral system in the family physician program in Isfahan metropolitan area in 2018.

This was a qualitative study with a contractual content analysis conducted on a sample of 28 individuals selected by purposeful snowball sampling continued until saturation. Interviews were held with male and female healthcare workers (n = 14), midwives (n = 10), and managers (n = 4). Data analysis was done using the SPSS.25 statistical software.

This study succeeded to explain strategies to improve the quality of the referral system and the views of health service personnel and, finally, find the strengths, weaknesses and solutions for improving the referral system.

The findings show that the performance of the referral system in the city of Isfahan is in line with the goals. However, visiting referred patients, providing feedback and referral to the laboratory are not as effective as they should be. Therefore, planning is needed to remove obstacles and solve problems such as shortage of human resources, non-human resources and infrastructure, insufficient provision of medicines and job insecurity so that goals can be reached.