Health referral rules ‘sickly’, says report

A poor referral system has been identified as the key cause of perennial congestion in two of the county’s main hospitals.

A study conducted by the Laikipia County Health Department found that the referral facilities were overburdened by patients with minor medical issues, which could be handled by lower-level facilities, who sought treatment in the busier hospitals.

“In many instances, cases of medical malpractice such as misdiagnosis happen because medical staff are overstretched,” said Health Chief Officer Donald Mogoi.

Dr Mogoi was presenting report findings on investment strategy in the county government’s referral system.

The report noted that an influx of ailments such as flu and malaria clogged the health system and led to poor services, overcrowded facilities and overworked medics.

Laikipia County has two referral hospitals; Nyahururu and Nanyuki, and thousands of referrals from less-busy health care centres have made efficiency in patient management an uphill task.

Ideally, patients should seek services from the primary health facilities in their locality while the referral system is meant to handle cases that need specialist care.

1,500 outpatients

At the Nanyuki Hospital, for instance, there are between 1,300 and 1,500 outpatient cases handled every day. Mogoi noted that a good referral hospital should handle between 200 and 300 cases that have been referred from primary centres.

There are 82 other public primary health facilities in the county where ailments such as respiratory infections should be handled.

“What we are trying to analyse is the perception of people about local health centers and the big hospitals. We want to understand why a patient would choose to be attended at Nanyuki Hospital and not at the local health centre in their area,” said Governor Ndiritu Muriithi.

The key issues highlighted as to why patients shun local dispensaries include medics having irregular working days leading to some dispensaries being closed down, lack of clinical officers and failure to get basic services such as laboratory tests.

“Not every patient in a referral hospital needs to be there. It is even cheaper to get treatment at a primary facility compared to the secondary facility. We want to make sure that the big hospitals only attend to serious cases such as orthopedics, renal dialysis and major surgeries,” Mogoi said.

This means the county government will have to adequately staff the low-level facilities and install machines to provide basic services such as laboratory test equipment and X-Rays, among others.