Socio-economic and hospital interrelationship factors in medical care

Abstract

In order to elucidate socio-medical factors involved in the medical care system, for example the relationship between physicians and patients, or the interrelation of medical institutions, an interview survey was conducted in the period from 1961-1964 which included 2, 696 patients under internal medicine as well as those under surgery in nineteen different hospitals.Results are summarized as follows:1. Many of the patients, roughly 66% stated that they went to “Home doctors”. In spite of this they shifted to other physicians without consulting their “Home doctors”. This indicates a relationship which is neither binding nor obligatory.2. Shifts to more than three different doctors were reported. These took place without the consent or approval of the “Home doctor”. The ratio of unauthorized shifts increased depending on the rising frequency of the shifts.3. Among the surveyed hospitals the judgements of the attending doctors were that directions given to the patients for hospital admission were untimely in light of their particular ailments.4. Following discharge from the hospital the patient often had follow up care from the out patient department at the same hospital, hence the “Home doctor” was left out of the picture.5. Affinity of patients to their “Home doctor” appeared weak and superficial and the interrelationship among medical institutions poorly arranged. Commercialization of medical management could be a contributing factor.