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Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders

Bartholomew S. Eze Orcid Logo, Mari Jones Orcid Logo

African Journal of Primary Health Care & Family Medicine, Volume: 14, Issue: 1

Swansea University Author: Mari Jones Orcid Logo

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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...

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Published in: African Journal of Primary Health Care & Family Medicine
ISSN: 2071-2928 2071-2936
Published: AOSIS 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa61793
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first_indexed 2022-11-28T16:10:44Z
last_indexed 2023-01-13T19:22:47Z
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spelling 2022-11-28T16:12:29.9449262 v2 61793 2022-11-07 Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders 8e326860810f5f960b088db10ef58906 0000-0001-9661-4899 Mari Jones Mari Jones true false 2022-11-07 PHAC 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. Journal Article African Journal of Primary Health Care &amp; Family Medicine 14 1 AOSIS 2071-2928 2071-2936 dual practice; physician self-referral; patient diversion; physician; public hospital; Nigeria 31 10 2022 2022-10-31 10.4102/phcfm.v14i1.3271 COLLEGE NANME Public Health COLLEGE CODE PHAC Swansea University The authors received no financial support for the research, authorship and/or publication of this article. 2022-11-28T16:12:29.9449262 2022-11-07T12:08:56.0682965 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Bartholomew S. Eze 0000-0001-9469-7440 1 Mari Jones 0000-0001-9661-4899 2 61793__25940__43fc57c75b354ad98c23536129279844.pdf 61793.pdf 2022-11-28T16:11:04.0248812 Output 1059015 application/pdf Version of Record true © 2022. The Authors.This work is licensed under the Creative Commons Attribution License true eng https://creativecommons.org/licenses/by/4.0
title Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
spellingShingle Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
Mari Jones
title_short Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
title_full Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
title_fullStr Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
title_full_unstemmed Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
title_sort Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders
author_id_str_mv 8e326860810f5f960b088db10ef58906
author_id_fullname_str_mv 8e326860810f5f960b088db10ef58906_***_Mari Jones
author Mari Jones
author2 Bartholomew S. Eze
Mari Jones
format Journal article
container_title African Journal of Primary Health Care &amp; Family Medicine
container_volume 14
container_issue 1
publishDate 2022
institution Swansea University
issn 2071-2928
2071-2936
doi_str_mv 10.4102/phcfm.v14i1.3271
publisher AOSIS
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
document_store_str 1
active_str 0
description 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.
published_date 2022-10-31T04:20:53Z
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score 11.016235

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