FAQs

The referral is the process of directing or redirecting the patient to the optimal level, usually from the lower potential levels to the greatest potential ones. 

Causes of referral are:

• Diagnosis request
• Diagnosis confirmation
• Specialized medical treatment
• Surgical intervention
• Conducting laboratory tests or advanced researches   

General objectives of the Referral System:

• Raising standards of the medical services: The consistent monitoring of the reasons behind patient’s referral among the levels of the primary health care up to the more specialized ones, facilitating the development of effective initiatives to raise its medical standards and also making the resources at the levels of medical service based on the required specialized needs.
• The optimal use of resources: Raising the efficiency of the services by the optimal use of the available resources without using them excessively in non-intended purposes and then maximizing their economic returns.
• Good medical service for the patients: Providing the opportunity for the patient in need of referral to get an integrated, fast and proper medical service to contribute in limiting the risks of complications as well as easing the patient's suffering physically, psychologically and economically.   

They are the pathological cases which threaten the loss of life or an organ. Such cases are referred based on a direct medical decision without the need to have the request approved by the hospital, only notifying a hospital of the arrival time of the patient, who will be directly referred without and delay.  

They are the pathological cases which are in need of medical referral based on the medical decision within a maximum period of 24 hours.

They are the pathological cases who are in need of medical care in hospitals or medical referral based on the medical decision within a maximum period of 3 days.

They are the pathological cases who are in need of follow-up and evaluation at the outpatient clinics; however, the patient should be notified of the exact date of referral within a maximum period of 7 days.

It is the hospital which requests transferring a patient to another level for the purpose of providing medical services that are not available in it.

It is the hospital to which the patient is referred.

It is medical care provided at the level of primary health care centers and it is the first point of contact for the patient with the health system. It includes basic health care services, such as health education, vaccination against the preventable infectious diseases, maternity and child health care, provision of essential drugs and appropriate treatment of common diseases and injuries.

It is health care offered at the level of general hospitals, which provide hospitalization services for the pathological cases and include major medical specialties. Patients are referred to such hospitals coming from the primary health care centers.

It is health care provided at the level of referential and specialized hospitals and includes all essential medical specialists as in general hospitals, in addition to the other sub-specialties. Patients are referred to such hospitals coming from the general hospitals.

It is health care provided at medical cities (King Fahad Medical City in Riyadh, King Saud Medical City in Riyadh, King Abdullah Medical City in Makkah, University Hospital, National Guard Hospitals, Ministry of Defense Hospitals and Security Forces Hospitals). At these health facilities, advanced medical services are provided, such as organs transplant, bone morrow transplant, advanced heart and brain surgeries and others. Patients are referred to such medical cities coming from the specialized hospitals. 

It is the classification of patients in terms of their eligibility for treatment at the MOH's hospitals, other governmental or private health sector in accordance with the regulations of the Kingdom of Saudi Arabia, whether for citizens or non-Saudi residents.

They are facilities of the MOH and other governmental and private health sector.  

The referral in this system is done from a secondary level to the same level, or from a secondary to a third level (Referential and specialized hospitals) within the same region and through the treatment eligibility and medical coordination departments in hospitals. The referral outside the same region is done through the treatment eligibility and medical coordination department at the directorates levels.

Referral levels among the different medical levels:

• Treatment outside the Kingdom
• The third level (specialized centers and hospitals)
• The second level (general hospitals)
• Primary health care (health centers)

- The referral in this system is done from the first to the second level or from the second to the third level (health centers and hospitals) within the same region and through the treatment eligibility and medical coordination departments in hospitals.

 - The referral outside the region is done through the treatment eligibility and medical coordination departments at the directorates' level. 

The referred-to hospital is identified as per a medical report from the treating doctor as well as availability of the requested service at the referred-to hospital through an electronic system applying specific policies that put the patient at the center of attention and ensure his access to the service appropriate for his condition.

You may check the treatment eligibility at your hospital or the one which requested your referral. Also, you may contact the MOH's call center via the phone number: 937 or 014062776.

The hospital is selected as per the medical decision and availability of the service at the referred-to hospital, taking into account the geographical aspect during the referral process.

The percent of the medical services offered at the different health care sectors in the KSA during 1432H:

• 58.9% for the MOH
• 21.1% for the private sector
• 20% for other governmental sectors

Access to Medical Services:

Treatment outside the Kingdom

The third level (specialized centers and hospitals)

The second level (general hospitals)

Primary health care (health centers)

Ambulance

Self-Referral

Official Transfer

The benefits of application of the Referral System: Citizens

• Early detection of cases
• Providing specialized services
• Reducing the waiting time for the patient due to the reduced rate of visits to the outpatient clinics in hospitals.
• Giving the doctor ample time to better examine the patient.
• Reducing the waiting list of surgeries and hospitalizations. 
• Getting the proper service compatible with the patient’s health condition.  

The benefits of application of the Referral System: Services providers:

•  The optimal use of the available resources
• Getting acquainted with the training requirements for doctors
• Organizing a program of continued medical education for the workers in the health sector
• Enabling the specialist to examine and treat cases in need of specialized care.
• Identifying the disease incidence in the different geographical regions of the Kingdom.
• Continuous care for chronic diseases, after counting them.
• Rationalizing the use of medicines. 

The benefits of application of the referral system: Health service facilities

• Activating the role of the primary health care units.
• Easing the burden on hospitals.
• Enabling the hospital to play its essential role in conducting health researches, dealing with specialized cases, training doctors and conducting medical tests, x-rays and surgeries.  

• A request to transfer a patient from a hospital to another.
• The approval to transfer a patient from a hospital to another electronically.
• Attaching the patient's medical report electronically to facilitate the procedures before his arrival as an emergency case, so that the doctor can check such a report when needed.
• Reducing the administrative burden and following up the transfer process automatically.
• Speeding up the transfer of patients from a hospital to another.
• Following up and finding out reasons for rejecting the transfer process by the hospital, to which the patient is transferred.
• Overcoming the obstacles preventing the referral, if any, in connection with the Ministry. 

Visit the MOH Portal: www.moh.gov.sa

Call the free toll number: 937