1 Ninava Health Directorate/ Iraq

2 College of Medicine, Ninava University / Iraq


Background: Referral is a dynamic process and it had been recognized as crucial since the Alma Ata declaration in 1978. Hospitals are overcrowded with patients who could be more cheaply treated in smaller facilities is a common feature of poorly functioning Referral System. Objective: This study aimed to assess patients‘ experience with quality of patient referral between levels of health care. Methods: A cross-sectional study was conducted in Mosul. A questionnaire was administered to 406 patients formally referred to al-Mosul General Hospital. Data was collected on socio-demographic characteristics of referred patients, appropriateness of referral process, and patient satisfaction. Result: The mean age of the group was 28.25 + 18.29 years and female's form (55.4%) of clients, (49%) believes that the referral process was appropriate. Two third of patients believe that three to four areas of the referring process was appropriate, while (65.5%) of clients were satisfied, with the treatment provided, that only statistically significant for type of referring center. Conclusion: Patients in this study view the referrals to higher levels of care as appropriate, with a high rate of referral to obtain diagnosis, to get specific treatment, and self-requested referrals that not be explained by socio-demographic characteristics of the patients, and most of them were satisfied by services provided through referral.