About this Research Topic

Background

The referral service is the process in which the responsibility of a patient's care is transferred and shared between the providers of the same, or higher level of health care service. Insufficient resources and lack of requisite skills, knowledge, and equipment to address the health needs of patients are the usual reasons for effecting a referral. Globally, operational procedures and policy frameworks in referral services are influenced by contextual issues and therefore differ from country to country as do the challenges associated with it. However, referral services are reliant on policy guidelines and frameworks to ensure public health needs are considered. Therefore, it is important to consider not just the challenges in enacting these policies, but also the environment within which these policies are implemented.

Prompt and effective referral services ensure that patients have timely access to healthcare professionals. However, in low-and-middle-income countries, referral services are mainly ad-hoc and largely uncoordinated; leaving a huge gap between policies and practices. In most instances, referral services have been seriously hampered partly by people’s perception, cost of care, inadequate funding, the distance between or to health facilities, and lack of effective transportation services. These all constitute challenges in varied aspects of referral services which can be addressed by policies and policy frameworks. Additionally, systemic issues at the institutional level, such as poor follow-up and feedback mechanisms further compound the situation. In the context of weak health and economic systems, poor organizational infrastructure and health insurance schemes, implementing referrals for occupational health and safety for employees as well as individuals who are victims of domestic violence can be challenging in the absence of relevant policy guidelines.

On the other hand, referrals in high-income countries are regularly confronted by long waiting times, mostly due to the large number of patients wanting to consult a specialist. The inability to triage clients has manifested significantly in treatment delays experienced in most European and American health care systems. This can be linked to the dynamics of international referrals within the global context of medical tourism and other health and systemic issues. Evidently, these types of collaborations require a high-level policy framework to guide the roles of medical tourism facilitators (MTFs)—who refer clients from low-and-middle-income countries to high-income countries and vice versa needs examining.

This Research Topic welcomes manuscripts that address policy issues within the diverse components of referral services such as referral staff, procedures, referral guide, monitoring and evaluation, management and oversight, and organizational partnerships. Also, policy issues relating to maternal and child health, HIV-AIDS, triage in referral, referral experience with hard-to-reach-population, frameworks for data and information use on referrals, frameworks for e-referral systems, referral for victims of domestic violence/abuse, occupational health and safety and client’s perception of referral services are welcome. While the main interest will be empirical research articles using either or both quantitative or qualitative methods, papers adopting systematic reviews and case studies will be considered.

Keywords: Health care Policy, Policy Framework, health care referral, quality health, low- and middle-income countries, health care systems

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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