Patient Views for Self-Referral to Specialists

Background: except in emergency cases, all patients should be seen first by a primary health care physic ian who decideswhether a referral to secondary care is necessary. the present stud y examined the reasons for patient self-referral to specialists.methods: a random sample of 1036 individuals was selected from people attending public outpatient clin ics andspecialist s' offi ces in the privat e health sector. of the sample, 40% were insured by the closed loop referral; 14% by thesemi-closed-loop referral; and 46% were open referral. the data were analysed using x2 statistical test. results: of theclosed-loop referral system patients, 6.8% were self-referred, as were 29 .7% of semi-closed referral system patients and75.5% of open referral system patients. there was a significant association between insurance type and patient self-referralto specialty care (x2 = 504; p< 0.000 i). the main reasons patients gave for by-passing ops and self-referring to specialistswere: the specialist 's high degree of sk ill in the specific area of the health problem (54%); waste of time to see the op for areferral (14 .9%). conclusion: the findings of this study demonstr ate the high degree of differen ce in the rates of referral byop and self-referral according to the health care del ivery system.