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Background: The referral system constitutes a key element of health system. Effective referral system between different levels of health care delivery represents a cornerstone in addressing patients’ health needs. Objectives: To assess the referral system Baghdad/ Al-Rusafa Health Directorate by evaluation the referral pattern and identify the quality of the referral letters and feedback reports. Type of the study: This cross-sectional study. Methodology: It was conducted in5PHCC in from 1st July 2015 - 31st December 2015 at Bagdad/Al-Rusafa health directorate. The study population (sampled population) included all referrals in six months. Data were entered and analyzed by using the statistical package for social science (SPSS) software version 17 for windows. Results: The referral rate was 2.85% .The variables of the referral letter (such as age, gender of the referred patient)were present, while the indication for referral(3.3%), result of investigation done in PHCC (4.67%), initial diagnosis (5.86%), however, the name of physician and signature were not mentioned or specified in 70% of the referral letters. The rate of feedback reports received by PHCCs was 19% of total number of referrals to the hospitals. The referral rate was (2.8%) from total number of patients seen in PHCCs. However, the quality of referral letters and feedback reports was poor in 69.5% and 78.5% respectively. Conclusion: In this study there was a low referral percentage and low feedback report in five PHCCs of Baghdad/ Al-Rusafa health directorate compared to international literature.The quality of referral letters and feedback reports is poor and contained inadequate information and lacking important and relevant items in majority of referral needs to be improved

Quality of Primary Care Center Referral Letters and Feedback Reports among Sample of PHCCs in Baghdad /Al-Rusafa Health Directorate During2015