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Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
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Mari Jones
African Journal of Primary Health Care & Family Medicine, Volume: 14, Issue: 1
Swansea University Author:
Mari Jones
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© 2022. The Authors.This work is licensed under the Creative Commons Attribution License
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DOI (Published version): 10.4102/phcfm.v14i1.3271
Abstract
Background: Physician self-referral occurs where a full-time paid doctor diverts patients from one hospital to another in which he or she has financial interest.Aim: This study is aimed at investigating the views of service users, physicians and policymakers on physician self-referral practice in pu...
| Published in: | African Journal of Primary Health Care & Family Medicine |
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| ISSN: | 2071-2928 2071-2936 |
| Published: |
AOSIS
2022
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa61793 |
| Abstract: |
Background: Physician self-referral occurs where a full-time paid doctor diverts patients from one hospital to another in which he or she has financial interest.Aim: This study is aimed at investigating the views of service users, physicians and policymakers on physician self-referral practice in public hospitals in Nigeria.Setting: The study was carried out in Enugu urban area of South East Nigeria.Methods: A mix of qualitative and quantitative methods was used to collect information from different categories of stakeholders. Service user views were explored through analysis of four focus group discussions involving 26 participants and 407 questionnaires completed with household members who had recently visited a public hospital and then gone to private hospitals. In-depth interviews were completed with 15 public sector doctors not involved in dual practice and eight key policymakers.Results: Thirty-four of 407 respondents (8.4%) visiting a public hospital were diverted to a private facility associated with the attending public hospital doctor. The research examined age, gender and socio-economic status (SES) as factors that might influence the likelihood of patient diversion. Advice to transfer to a private clinic usually came directly from the doctor involved but might also come from nurses.Conclusion: Physician self-referral in Nigeria could take different forms. It was found that both direct and indirect forms of diversion exist, suggesting that this is an organised practice in which dual-practice doctors and supporting hospital staff members cooperate. The study recommends, among other things, that service users should be adequately protected from any form of diversion to private practice by the public system employee doctors. |
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| Keywords: |
dual practice; physician self-referral; patient diversion; physician; public hospital; Nigeria |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
The authors received no financial support for the research, authorship and/or publication of this article. |
| Issue: |
1 |