Study On The Cognition Of Both Doctors And Patients On Dual Referral In A Region Medical Alliance In Hunan Province

Objective:carrying out an investigation on the recognition of doctors and patients on two-way referral in a regional medical alliance, the study aims to understand the awareness of two-way referral among doctors and patients of levels of the hospital, combining with reasons and opinions from doctors and patients regarding the malfunctioning of two-way referral, thus to provide policy making suggestions for fluent functioning of two-way referral among levels of hospitals in the medical alliance.Methods:use stratified random sampling.17ward of99hospitals were extracted from a medical alliance; take the completely random sampling, extract570doctors and patients. Through the application of self-made two-way referral questionnaire to the doctors and patients.Results:(1)12.6%of doctors do not understand the two-way referral,26.1%of patients do not understand the two-way referral.(2)rate of recognition of dual referral of doctors’varies, while that of patients shows no statistical significance. The training held by hospitals is the major approach by which doctors gain information about two-way referral, and patients are mainly informed by doctors of information about two-way referral. Both doctors and patients consider that the upwards referral and down referral dominant among the forms of the two-way referral; the majority of doctors approve of the implementation of dual referral, while patients’ attitude toward dual referral varies. Both doctors and patients hold that the determinants on dual referral depend on patients. With regard to doctors’attitude towards medical insurance incentive expectation of two-way referral, there exists statistical significance, but there exists no statistical significance with regard to that of patients; the doctors’ satisfaction evaluation of the performance of dual referral differs from patients; doctors from different levels believe that regional medical treatment promotes two-way referral, showing statistical significance in distribution. They think it necessary to set up referral managing agency, and there exists statistical significance with regard to its distribution. Doctors’advocating helps to practice two-way referral; patients are more willing to take downwards referral within the cooperative medical system, and there exists statistical significance.(3) Approval of implementing two-way referral system and publicity serve as influencing factors of the rate recognition of doctors; and the satisfying degree is an influencing factor of the rate recognition of patients.Conclusion:(1)199doctors surveyed,87.4%of doctors understand the two-way referral;326patients surveyed,73.9%of patients understand the two-way referral.(2) Approval of implementation of the two-way referral system serves as influencing factors of the recognition rate of doctors.(3) The satisfying degree on the performing dual referral system is an influencing factor of the recognition rate of patients.(4)It helps to form the coordinating mechanism of dual referral by applying health policy, medical benefits funding and organizational management strategy to coordinate the conflict of interest among hospitals, patients, health insurers and government.