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Table 2 Reasons for outward referral by initiating health facility level

From: Surgical referrals in Northern Tanzania: a prospective assessment of rates, preventability, reasons and patterns

Type of reason Reason for outward referral Initiating health facility levela
Health Centers
N = 91
n (%)
District Hospitals
N = 382
n (%)
Regional Hospitals
N = 270
n (%)
Total
N = 743
n (%)
Staff capacity Need for specialist care 29 (31.9) 291 (76.2) 222 (82.2) 542 (72.9)
Lack of post-operative care 0 (0.0) 18 (4.7) 16 (5.9) 34 (4.6)
Need for imaging equipment training 7 (7.7) 6 (1.6) 6 (2.2) 19 (2.6)
Member of surgical team not available 0 (0.0) 3 (0.8) 17 (6.3) 20 (2.7)
Need for laboratory diagnostic training 0 (0.0) 6 (1.6) 2 (0.7) 8 (1.1)
Equipment Lack of imaging diagnostic equipment 30 (33.0) 154 (40.3) 99 (36.7) 283 (38.1)
Lack of laboratory diagnostic equipment 14 (15.4) 25 (6.5) 46 (17.0) 185 (24.9)
Non-functional imaging diagnostic equipment 2 (2.2) 26 (6.8) 2 (0.7) 30 (4.0)
Non-functional laboratory diagnostic equipment 0 (0.0) 15 (3.9) 0 (0.0) 15 (2.0)
Drugs and supplies Lack of medical supplies and consumables 1 (1.1) 18 (4.7) 44 (16.3) 63 (8.5)
Lack of drugs 7 (7.7) 44 (11.5) 5 (1.9) 56 (7.5)
Lack of blood 17 (18.7) 19 (5.0) 4 (1.5) 40 (5.4)
Lack of oxygen/water/electricity 1 (1.1) 5 (1.3) 0 (0.0) 6 (0.8)
Infrastructure OR not functional 0 (0.0) 1 (0.3) 1 (0.4) 2 (0.3)
Lack of inpatient beds 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)
OR occupied 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)
Patient preference Patient preference 2 (2.2) 6 (1.6) 2 (0.7) 10 (1.3)
Other Other 0 (0.0) 1 (0.3) 0 (0.0) 1 (0.1)
  1. a Referrals total more than 100% because there could be more than one reason for referral per patient