| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 85 === Referral is an essential and nautral behavior in medical care
systemto provide optumal care to patient. However, the effect of
referral in Taiwan is not clear and ideal. The purpose of this
study is to examine the consumption of medical resources by
referral patients and to compare the consumption of
medicalresources between referral and non-referral patients.Data
werecollected from referral patients with top 20major diagnoses
(based on ICD-9-CM) and their non-patients counter part in two
medical centers.In addtion,Iuse a questionnaire to gather
information from the referral patient concerning their
behaviors,and decisions of referral,and the use of medical
examination and inspection before and after the referral.
Major findings oh this study are as follows:1)The age
distribution are different between the referral and non-
referral.2)Under the same major disnoses,total charge,the length
of stay,and number of orders,do not have a significant
difference between the referral inpatients and non-referral
inpatients.That is, the consumption of medical resources by
the referral group is not different from the non-referral
group.3)The decision of referral,in term of choosing a hospital
or a doctor,mostly made by primary physicians for patients in
hospital B.Conversely, patients and their families in hospital
A play a more important role in decision making compare with
those in hospital B.4)When patients had been examined or
inspected before referral,all of them must be examined or
inspected once in hospital A.The propotion of repeated process
in hospital A (100%) is higher than in hospital B. For
patients with severe conditions, formal referral procedure may
not save or lessen the resource consumption than non-referral
patient.Knowing that on study examine only a past of the
referral system,we still think that government should evaluate
the referral system once again, and try another way to make the
referral system once again,and try another way to make the
system work better.
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