Design of a Model for Management of Referral System in the Iranian Urban Family Physician Program

Background: The purpose of this research was to identify the main dimensions of management of referral systems in family physician program and then introduce them to policymakers of the country primary health care. Methods: This descriptive-correlation study was designed in Mazandaran Province, northern Iran (2017). The participants were employees of health centers of Mazandaran and Fars Provinces, Iran. The dimensions influencing on the referral system were identified systematically in the selected countries by using researcher-made questionnaire according to a statistical method called Factor Analysis. The data sufficiency was evaluated by the Bartlett's and Kaiser-Meyer-Olkin’s tests. Reliability of test was calculated and confirmed according to Cronbach's Alpha and Combined Reliability tests. Validity of the test was calculated and confirmed based on the average variance extracted (AVE). Results: In confirmatory factor analysis, coefficient of effect of Electronic Health Record on referral system (as the most important dimension), coefficient of Family Physician, coefficient of structure of insurance, coefficient of policymaking in health care system, coefficient of proper stewardship of health system, and basic health care services, were 0.887, 0.877, 0.860, 0.804, 0.568, and 0.522, respectively. Conclusion: Six effective dimensions including Electronic Health Record (as the most important dimension), family physician, structure of insurance, policymaking in health care system, proper stewardship of health system, and basic health care services were identified. According to six effective dimensions on management model of the referral system in the Iranian urban family physician program, the health system authorities pay serious attention to the six identified dimensions of the current study to improve the health of the urban community.