Patient Profile and Referral Pattern in a Tertiary Care Infectious Disease Hospital of Bangladesh: A Cross-Sectional Study.
Hasan Mohammad Jahid MJ, Rabbi Mohammad Mehedi Hasan MMH, Chowdhury Abdullah Al Tahsin AAT, Hasan Zubayer Z et al.
Introduction Infectious diseases are attributable to a large proportion of the disease burden in Bangladesh. The disease profile and referral pattern of these patients are important for understanding healthcare utilization and improving system efficiency in resource-limited settings. Hence, the objective of the present study was to assess the patient profiles and referral patterns at the Infectious Diseases Hospital (IDH), Dhaka, Bangladesh. Methods This cross-sectional study was conducted at IDH, Mohakhali, Bangladesh. Using a systematic sampling, a total of 308 patients (161 outpatients and 147 inpatients) were recruited. Data regarding patients' sociodemographic, diagnosis, and referral were collected through face-to-face interviews using a semi-structured questionnaire. Descriptive statistics were used to represent the findings. Results The mean age of the patients was 31.5 years (standard deviation, SD 16), with 66% (n=204) being male subjects and 56% (n=172) residing in urban areas. Among outpatients, 93% (n=150) presented with animal bites or scratches, while inpatients presented with more severe conditions, including contagious viral infections (28.6%, n=42), tetanus (26%, n=38), and acquired immune deficiency syndrome (AIDS) (25%, n=37). Overall, 39.6% (n=122) of patients were institutionally referred, with higher referral rates among inpatients (68%, n=100) than outpatients (13.7%, n=22). Primary care facilities accounted for 33% (n=40) of institutional referrals. Inadequate treatment facilities (54%, n=54), shortages of specialist physicians and other staff (41%, n=41), insufficient diagnostic facilities (33%, n=33), and inadequate vaccine or medicine supply (22%, n=22) were the most common reasons for both institutional and self-referral. Conclusion A substantial number of patients were self-referred at IDH. Strengthened primary care infrastructure and referral systems would optimize tertiary care utilization and improve healthcare access in Bangladesh.