Reports Outline Health Insurance Study Findings from Second Military Medical University (Practices and attitudes of doctors and patients to downward…

Managed Care Weekly Digest

Reports Outline Health Insurance Study Findings from Second Military Medical University (Practices and attitudes of doctors and patients to downward referral in Shanghai, China)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Research findings on Health Insurance are discussed in a new report. According to news reporting out of Shanghai, People's Republic of China, by NewsRx editors, research stated, "In China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics."

Our news journalists obtained a quote from the research from Second Military Medical University, "Doctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling. The questionnaire surveyed their sociodemographic characteristics, attitudes towards CHSs and hospitals, understanding of downward referral, recognition of the community first treatment system, and downward referral practices and willingness. Descriptive statistics, ch test and stepwise logistic regression analysis were employed for statistical analysis. Only 20.8% (161/773) of doctors were willing to accept downward referrals, although this proportion was higher among patients (37.6%, 326/866). Doctors' willingness was influenced by education, understanding of downward referral, and perception of health resources in hospitals. Patients' willingness was influenced by marital status, economic factors and recognition of the community first treatment system. Well-educated doctors who do not consider downward referral would increase their workloads and those with a more comprehensive understanding of hospitals and downward referral process were more likely to make a downward referral decision. Single-injury patients fully recognising the community first treatment system were more willing to accept downward referral. Patients' willingness was significantly increased if downward referral was cost-saving. A better medical insurance system was another key factor for patients to accept downward referral decisions, especially for the floating population. To increase the rate of downward referral, the Chinese government should optimise the current referral system and conduct universal publicity for downward referral. Doctors and patients should promote understandings of downward referral. Hospitals should realise the necessity of downward referral, effectively reduce workloads and provide continuing education for doctors."

According to the news editors, the research concluded: "Increasing monetary reimbursement is urgent, as is improving the medical insurance system."

For more information on this research see: Practices and attitudes of doctors and patients to downward referral in Shanghai, China. Bmj Open, 2017;7(4):e012565. (BMJ Publishing Group - group.bmj.com/; Bmj Open - bmjopen.bmj.com/)

Our news journalists report that additional information may be obtained by contacting W. Yu, Institute of Military Health Management, Second Military Medical University, Shanghai, People's Republic of China. Additional authors for this research include M. Li, X. Nong, T. Ding, F. Ye, J. Liu, Z. Dai and L. Zhang (see also Health Insurance).