A Decongestion Framework for Addressing Patients' Self-Referral Crisis within a Health Facility: Case of Kisil Teaching and Referral Hospital, Kenya

This paper focuses on addressing the crisis advanced by patient’s self-referrals through a proposed decongesting framework. Observably, a referral framework enables control of client health demands that cannot be met locally. It is a common occurrence that patients walking into referral hospitals increases thus resulting in the overuse of available services and a deterioration of the facility’s standard of care. In this work, a descriptive research design was adopted where self-referral patients who visit the outpatient department at Kisii Teaching and Referral Hospital were interviewed. Purposive random sampling was used to pick interviewee from the facility. Respondents were provided with questionnaires to answer, and the data was analyzed quantitatively using the Statistical Package for Social Sciences (SPSS). Quantitative data were presented in the form of tables and pie charts, quantitative methods (descriptive and inferential analysis) such as frequencies and percentages were used. The resulting framework is expected to aid in the decongestion of patient self-referrals. The findings established a significant positive relationship (r=.7438) between Socio-Demographic Factors and hospital decongestion in the referral hospitals. The study highlighted a positive relationship (r=.703) between primary health facility characteristics and hospital decongestion. The study established a positive relationship between Referral Facility Characteristics (r=.431) and hospital decongestion. The study established a positive relationship between Referral Facility Characteristics (r=.431) and Decongestion Framework. The study findings highlighted that a unit increase of 0.01 by Referral Facility Characteristics could increase hospital decongestion of referral hospitals. The study findings also revealed that the administrative factors also influenced the level of referral hospital congestion. The study recommends the need to strengthen the referral mechanism and linkages between the various levels of the facility by having a healthcare provider coordinate referral processes through the provision of healthcare services in remote areas via mobile clinics. Increase collaboration between all levels of care and introduce the use of technology in communication, such as the use of EHR and mobile phones for receiving feedback and sending referrals to enhance proper communication within the health care system. The public and the healthcare providers are to be updated on the referral guidelines.