Abstract
Objective To learn influencing factors on tiered medical services and two-way referral in Zhejiang for feasibility recommendations of building the tiered medical services based on community first-visit practice. Methods Stratified sampling was made according to economic development levels, for qualitative interview of the 137 health administrators and medical workers from five cities and 9 counties in Zhejiang.The purpose of this effort is to learn the establishment of the first-visit in community and tiered medical services and their influencing factors. Results Poor regulation by medical insurance policies, medical competency, merit pay system and essential medicine system were influencing factors on community medical services. Conclusion The government should take the lead in building an information platform between large hospitals and primary healthcare institutions, guiding the establishment of tiered medical services and two-way referral system by means of better medical insurance policy and drug policies. Key words: Zhejiang province; Tiered medical services; Two-way referral system; Survey
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