Unnecessary referrals adversely affect the efficiency of tertiary hospitals in the valley

New Delhi: Unnecessary referrals adversely affect the performance and efficiency of tertiary hospitals in the valley that have been suffering owing to unregulated referral system and subsequently the heavy rush of patients. The health centres in rural areas continue to lack basic facilities due which the burden on city hospitals growing by the day. To catch up with the health institutions in the rest of India, the government has to take multi-pronged steps to revamp the ailing healthcare in the UT of J&K.
Standard Operating Protocol (SOP) meant for instituting answerability in health care centers for referrals are not followed properly. Many doctors working in tertiary health centers are of the opinion that most of the time SOP’s are being neglected as they continue to receive patients who can be easily managed at peripheral hospitals. The concerned authorities have also failed to enforce norms and guidelines regarding referral systems to ensure proper functioning of the health institutions. Too many “Referral In” cases from all the PHC’s & CHC’s to District Hospital Cause Exhaustion of local supplies and quality of patient care suffers. Frequent “Referral Out” cases add up to fuel wastage and pilferage resulting in professional misconduct and misuse of ambulance services.

Women’s Healthcare in India has always been a minor concern. In public/private hospitals, the ratio of doctor-patient numbers needs to be increased, as does the hospital staff and the number of hospitals. Hospitals in the cities lack the required staff structure. In rural areas, community healthcare centers, dispensaries, and hospitals are not easily accessible, they lack the proper infrastructure, or are unavailable. Women and Children become the most marginalized population in accessing healthcare facilities. Women’s reproductive health in India has suffered to date, with many women not even being aware of the problems that they are facing.

Women Healthcare situation in Jammu and Kashmir – “In comparison to India’s doctor-patient ratio of 1:2000, J&K has one doctor for 3866 people, compared to the WHO (World Health Organization) norm of one doctor for 1000 people.
First, the lack of poor or no healthcare infrastructure in the remote areas, the non-availability of doctors, and finally, the low doctor-patient ratio all of these conditions have contributed to the poor health outcomes for women in J&K.
This doctor-patient ratio raises concern for the patient and doctors and hospitals to suffer from it. Especially concerning the health issues faced by the women in J&K, majority of them who need obstetric care and run even the slightest risk are referred to the region’s solitary tertiary care maternity hospital – Lal Ded Hospital – in Srinagar. As a result, putting the burden on metropolitan hospitals adds to the pressure on doctors who are overburdened with patients. Patients are often negatively affected by their waistlines, delays in consultation, and

therapy, putting them in danger of aggravating the ailment they have, which can be cured/eradicated with appropriate intervention.

The government should take steps to address the problems of doctors and para-medicos and to improve the working conditions in the health institutions.
An expansion of healthcare infrastructure facilities in the rural areas of J&K is required with awareness and sensitization workshops on the importance of women’s healthcare.
There is also a dire need for effective monitoring of various health schemes so that common people can avail their benefits adequately. Various schemes of Health and Family Welfare Department and National Rural Health Mission (NRHM) need to be reviewed on periodic basis. The authorities should ensure close vigil on the hospitals. They should also check the growth of nursing homes conducting regular inspections and initiate action against those not fulfilling the mandatory norms and formalities. The pending projects should be completed in the scheduled timeframe. The government should also take steps to fill up the vacancies for the upcoming health institutions. There is also a need for furnishing the skills of doctors as per the latest developments in the healthcare sector. Short term refresher courses for doctors in premier institutions across the world should be arranged so as to acquaint them with latest trends in medical sciences. Out sourcing of facilities like sanitation, security, laundry and pantry should also be given a serious thought. Concerted efforts are needed to improve the healthcare in the UT and the government should accord priority to this sector in the real sense.

*Dr. Narresh Purohit-MD, DNB, DIH, MHA, MRCP(UK), is an Epidemiologist, and Advisor-National Communicable Disease Control Program of Govt. of India, Madhya Pradesh and several state organizations.)