Background: Referral system is one of the key elements in family health care facilities. Recently, Egypt has started to implement referral system that depends mainly on family physicians working in primary health care settings.
Objectives: The study aimed to assess the knowledge and practice of family health physicians about referral system and to detect their associated determinants.
Methods: A cross- sectional study on 138 physicians working in family health care facilities was conducted from October 2021 to December 2021. A structured self- administered questionnaire was used including socio-demographic data, questions regarding knowledge and practice about the referral system and suggestions to improve the referral system.
Results: Most of physicians had good knowledge and practice of referral system (65.2% & 94.2%, respectively). The good knowledge was significantly higher among physicians working in Accredited than non-accredited facilities (81.8% vs. 50%). Also the good practice was significantly higher among physicians of family health units than those working in family health canters (96.8% vs. 66.7%). Both knowledge and practice do not vary significantly according to most parameters studied. Development of referral guidelines, medical education reform, payment method reform and establishment of culture-building activities were suggested by physicians for improvement of referral system (97.8%, 94.2%, 97.8%, and 97.8%, respectively).
Conclusion: Good knowledge and practice of the referral system were showed by physicians working in family health facilities in Mansoura, Egypt. Facility accreditation and training programs are important factors for good knowledge and practice of the referral system.