General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐Synthesis
ABSTRACT Background and Aims For achieving an effective integrated primary health care, communication between healthcare providers is a key element. This study aimed to identify general practitioners' reported barriers to communication within referral systems and propose actionable strategies f...
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| Format: | Article |
| Language: | English |
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Wiley
2025-05-01
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| Series: | Health Science Reports |
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| Online Access: | https://doi.org/10.1002/hsr2.70785 |
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| author | Hamed Fattahi Faezeh Ghasemi Seproo Arash Fattahi Vahideh Rostami Azad Shokri |
| author_facet | Hamed Fattahi Faezeh Ghasemi Seproo Arash Fattahi Vahideh Rostami Azad Shokri |
| author_sort | Hamed Fattahi |
| collection | DOAJ |
| description | ABSTRACT Background and Aims For achieving an effective integrated primary health care, communication between healthcare providers is a key element. This study aimed to identify general practitioners' reported barriers to communication within referral systems and propose actionable strategies for improvement. Methods Guided by PRISMA 2020 guidelines, 22 qualitative studies from PubMed, Web of Science, Scopus, and ProQuest were analyzed using inductive thematic synthesis. Quality assessment followed Standards for Reporting Qualitative Research (SRQR) criteria. Results Four central themes emerged: structural barriers (subthemes: inefficient health system, shortages in the number of specialists and heavy workload), regulatory and procedural barriers (subthemes: lack of comprehensive communication protocols, unclear delineation of roles and responsibilities, inadequate economic incentives, lack of continuity between providers, lack of interest in specialists, time consuming communication process), technological barriers (subthemes: ineffective methods for communication, challenges in using electronic medical records), and personal and interpersonal barriers (subthemes: having different approaches to healthcare, inappropriate specialists' perceptions of general practitioners' roles, lack of professional trust and respect, social anxiety disorder in the workplace). Conclusion Health policymakers must prioritize structural and procedural reforms, including standardized communication frameworks, interoperable digital infrastructure, and interprofessional training programs. Addressing these gaps can enhance referral system efficiency, reduce diagnostic delays, and strengthen health system resilience, particularly in low‐resource settings. Trial Registration The protocol of the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on December 20, 2023 (Supporting Information S1). |
| format | Article |
| id | doaj-art-cc3f175f3a43463d9a3034ddb4be327e |
| institution | Kabale University |
| issn | 2398-8835 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj-art-cc3f175f3a43463d9a3034ddb4be327e2025-08-20T03:59:36ZengWileyHealth Science Reports2398-88352025-05-0185n/an/a10.1002/hsr2.70785General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐SynthesisHamed Fattahi0Faezeh Ghasemi Seproo1Arash Fattahi2Vahideh Rostami3Azad Shokri4Health Management and Economics Research Center, Health Management Research Institute Iran University of Medical Sciences Tehran IranCenter for Health Human Resources Research and Studies Ministry of Health and Medical Education Tehran IranDepartment of Neurosurgery, School of Medicine Iran University of Medical Sciences Tehran IranStudent Research Committee, School of Management and Medical Informatics Shiraz University of Medical Sciences Shiraz IranSocial Determinants of Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj IranABSTRACT Background and Aims For achieving an effective integrated primary health care, communication between healthcare providers is a key element. This study aimed to identify general practitioners' reported barriers to communication within referral systems and propose actionable strategies for improvement. Methods Guided by PRISMA 2020 guidelines, 22 qualitative studies from PubMed, Web of Science, Scopus, and ProQuest were analyzed using inductive thematic synthesis. Quality assessment followed Standards for Reporting Qualitative Research (SRQR) criteria. Results Four central themes emerged: structural barriers (subthemes: inefficient health system, shortages in the number of specialists and heavy workload), regulatory and procedural barriers (subthemes: lack of comprehensive communication protocols, unclear delineation of roles and responsibilities, inadequate economic incentives, lack of continuity between providers, lack of interest in specialists, time consuming communication process), technological barriers (subthemes: ineffective methods for communication, challenges in using electronic medical records), and personal and interpersonal barriers (subthemes: having different approaches to healthcare, inappropriate specialists' perceptions of general practitioners' roles, lack of professional trust and respect, social anxiety disorder in the workplace). Conclusion Health policymakers must prioritize structural and procedural reforms, including standardized communication frameworks, interoperable digital infrastructure, and interprofessional training programs. Addressing these gaps can enhance referral system efficiency, reduce diagnostic delays, and strengthen health system resilience, particularly in low‐resource settings. Trial Registration The protocol of the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on December 20, 2023 (Supporting Information S1).https://doi.org/10.1002/hsr2.70785barrierscommunicationgeneral practitionersprimary healthcarereferral systemspecialist |
| spellingShingle | Hamed Fattahi Faezeh Ghasemi Seproo Arash Fattahi Vahideh Rostami Azad Shokri General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐Synthesis Health Science Reports barriers communication general practitioners primary healthcare referral system specialist |
| title | General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐Synthesis |
| title_full | General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐Synthesis |
| title_fullStr | General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐Synthesis |
| title_full_unstemmed | General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐Synthesis |
| title_short | General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta‐Synthesis |
| title_sort | general practitioners perspectives on barriers to communication with specialists in the referral system a systematic review and meta synthesis |
| topic | barriers communication general practitioners primary healthcare referral system specialist |
| url | https://doi.org/10.1002/hsr2.70785 |
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