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Journal of Diabetes Research
Volume 2017, Article ID 4183604, 8 pages
Review Article

The Referral System between Primary and Secondary Health Care in Saudi Arabia for Patients with Type 2 Diabetes: A Systematic Review

1Department of Public Health, Faculty of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
2Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
3Nursing Education Departments, King Fahad Medical City, Riyadh, Saudi Arabia
4School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Bundoora, VIC 3083, Australia
5Adult Emergency Department, King Fahad Medical City, Riyadh, Saudi Arabia

Correspondence should be addressed to George Binh Lenon; ua.ude.timr@nonel.egroeg

Received 25 January 2017; Accepted 30 April 2017; Published 29 May 2017

Academic Editor: Andrea Scaramuzza

Copyright © 2017 Mohammed Senitan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. In Saudi Arabia, the mortality of diabetes is currently reported at 6%. A well-administered referral system is crucial in aiding the management of this disease. Method. A single reviewer employed a systematic approach to searching the literature databases with regard to the question: what are the attributes of referral systems in Saudi Arabia for patients with type 2 diabetes (T2D)? The results were analysed in order to provide recommendations to improve the Saudi health system. Results. Twelve primary studies were identified from a systematic search. Overall, the 12 studies did not clearly mention any of the factors of a good referral system. The referral problems identified by this study included patients’ unnecessary requests for referral, unstructured referral letters, and unclear dissemination guidelines for referral. Conclusions. This research attempted to identify the efficiency of the referral processes that were implemented for patients with T2D. The majority of the included studies were completely silent on the main referral factors for patients. If this review is representative of the referral system in Saudi Arabia, then, in the context of T2D, current referrals are unsafe. Further research on the quality of the referral system, taking into account at least some of the WHO referral guidelines, is required.