| Summary: | 碩士 === 臺北醫學大學 === 醫務管理學系 === 91 === Since the Bureau of the National Health Insurance initiated the “Global Budget Payment System” in July 2002, it has created a significant impact on the overall healthl service industry. In the foreseeable future, medical service providers will work from curing illness to disease prevention. The Bureau of the National Health Insurance also highlights the importance of the “Referral System” among medical institutions.
The three purposes of the survey were following:
1.Knowing primary physicians’ understanding about the “Referral System.”
2.Exploring factors influencing the willingness of primary care physicians for patient referrals.
3.Providing the study results to health policy makers.
The survey subjects were primary care physicians. A total of 2,045 questionnaires were mailed, while there was 25.5% returning rate. The survey showed that the majority of primary care physicians believed that referral can ensure patients to receive medical treatment constantly. Also, they prefer “half-open hospital system.” That “appointing physician helps patients to return” is good for primary care physicians to be entrusted by their patients. That “referral can eliminate malpractice efficiently” benefits both patients and hospitals. Additionally, primary care physicians were concerned that patients may not return once they were transferred or whether physicians of hospitals may insult them. Mutual respects among medical institutions can keep the good images of each other. The factors of primary care physician’s decision of referral their patients lie on the restraint on hospitals’ clinical service, the avoid of the waste of medical resources, and so on.
Suggestions for related authority:
1.IC circuit card should be put into effect as soon as possible, which helps to follow the card holder’s latest physical condition. In addition to avoid the waste of providing the repeat services by receiving hospitals, the card helps to monitor diseases. Therefore, severe epidemic such as the worldwide outbreak of SARS can be traced and avoided.
2.Health authority should be responsible to build up a website of the national medical service information network which integrates the referral information.
3.Medical service level should be simplified. The current three-level system should be changed to two-level system. Medical institutions should be categorized into teaching (referral hospital) and non-teaching (front-line medical providers). In that case, referral system can be carried out in an easier way.
4.Health authority should provide more incentive for referral. For example, the referral payment should be raised so patients don’t have to pay for co- payment such as medicine and check-up fee. Or, the co- payment for patients who receive medical service without being transferred should be raised.
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