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The Path to Referral System Acceptance Through the Complex Terrain of Trust in General Practitioners
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Fatemeh Paziyar   , Saeed Nojaba , Mohammad Azadi Ahmadabadi , Mohammad Saeed Saffari , Elyas Hadian Shiva , Hamid Izadbakhsh |
| in Health Policy, Tehran University of Medical Sciences, Researcher at Rushd Center of Imam Sadiq University, Tehran, Iran |
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Abstract: (32 Views) |
Background: The referral system aims to improve the efficiency and quality of healthcare services. It is based on two core components: health management and service stratification by general practitioners (GPs) and returning to the primary level for continued care under GPs’ supervision. In societies where patients often bypass primary care and directly visit specialists, implementing such a system requires changes in health-seeking behavior and greater trust in GPs as its foundation. This study aimed to assess the public’s acceptance of these two core components and examine their relationship with trust in GPs, using data from a national survey.
Methods: The study was conducted in July 2024 using an online national panel. Data were collected from 1,504 respondents through a structured questionnaire and analyzed using SPSS software. Acceptance of the referral system was measured with two items, and trust in GPs was assessed through five targeted items.
Results: About two-thirds of participants disagreed with GP-led health management and service stratification, and nearly half did not support returning to primary care for continued treatment. Overall, only 38.6% of respondents accepted both components of the referral system, while the rest rejected one or both. Significant associations were found between all trust dimensions and acceptance of the referral system.
Conclusion: Public acceptance remains a challenge in implementing the referral system. Enhancing trust in GPs plays a vital role in improving acceptance. Therefore, policies that promote public engagement and build trust may support the system’s successful implementation. |
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| Keywords: General Practitioners, Physician-Patient Relations, Referral and Consultation, Trus |
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Full-Text [PDF 1008 kb]
(8 Downloads)
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Letter: Original Article |
Subject:
General
Received: 2025/04/17 | Accepted: 2025/05/24 | ePublished ahead of print: 2025/07/8
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