Tayyaba Khawar Butt, Liaqat Ali, Zahid Anwar, Rehan Farooqui, Aman Ullah Khan.
Audit of referral documents accompanying admissions to Neonatology Unit in Children`s Hospital.
Pak Paed J Jan ;32(1):36-41.

Objective: To audit referral documents accompanying admissions in the Neonatology Unit of Children`s Hospital and the Institute of Child Health, Lahore with special reference to hypoxic ischemic encephalopathy, Design: Cross Sectional Analytic. Place and Duration: The study was carried out in the Neonatology Unit at The Children`s Hospital and the Institute of Child Health, Lahore from March 1, 2005 to June 30, 2005. Patients and Methods: All neonates presenting with the diagnosis of hypoxic ischemic encephalopathy (HIE) during the study period were included in the study. Controls were selected from neonates admitted on the same day in the Neonatology Unit. We compared the trend to send written referral notes between babies with birth asphyxia and other diagnoses, between doctors and other health care providers, and between areas of referral of patients (from Lahore compared to outside Lahore). Results: Total of 340 admission records including 153 cases and 187 controls were analyzed. Twenty two cases (14.4%) and 16 controls (8.6%) had accompanying referral documents (p value 0.09). Where the first contact was a doctor (57.6% patients), 34 cases (17.3%) were admitted along with a referral letter in comparison to 2.8% patients where first contact was a non-doctor (p value <0.0001). Eighty percent patients came from Lahore. Eighteen cases (6.6%) were given a referral letter in comparison to 20 cases (29.4%) who came from surrounding cities (p value <0.0001). Conclusion: Very few patients in our study group carried a referral letter. Babies with HIE were no more likely to carry a referral document. Patients were more likely to carry a referral letter where the first medical contact was a doctor or if they were referred from outside Lahore.

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