TY - JOUR
AU - H. Fattahi
AU - F. G. Seproo
AU - A. Fattahi
AU - V. Rostami
AU - A. Shokri
A1 - 
AB - 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).
AD - Health Management and Economics Research Center, Health Management Research Institute Iran University of Medical Sciences Tehran Iran.; Center for Primary Health Care Network Management, Deputy for Public Health Iranian Ministry of Health and Medical Education Tehran Iran.; Center for Health Human Resources Research and Studies Ministry of Health and Medical Education Tehran Iran.; Department of Neurosurgery, School of Medicine Iran University of Medical Sciences Tehran Iran.; Student Research Committee, School of Management and Medical Informatics Shiraz University of Medical Sciences Shiraz Iran.; Social Determinants of Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran.
AN - 40415981
BT - Health Sci Rep
C5 - Education & Workforce; HIT & Telehealth
CP - 5
DA - May
DO - 10.1002/hsr2.70785
DP - NLM
ET - 20250522
IS - 5
JF - Health Sci Rep
LA - eng
N2 - 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).
PY - 2025
SN - 2398-8835
SP - e70785
ST - General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta-Synthesis
T1 - General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta-Synthesis
T2 - Health Sci Rep
TI - General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta-Synthesis
U1 - Education & Workforce; HIT & Telehealth
U3 - 10.1002/hsr2.70785
VL - 8
VO - 2398-8835
Y1 - 2025
ER -