Abstract
Objectives: To evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methods: Obtaining data from regular reports from public medical institutions in Shanghai, comparing patients who seek doctors from out-of-Shanghai residence and local patients with insurance in terms of the quantity of service, types of diseases, medical expenses, etc. Results: External-care-seeking has a large quantity, especially in hospitalization. In 2012, the number of discharged population from out-of-Shanghai accounted for 22.74% of the total discharged number, the proportion even higher than 30% in tertiary hospitals. Tertiary hospitals have a significant attraction effect, concentrating 59.42% of the outpatient and emergency visits and 71.82% of the amount of hospitalization, with corresponding cost of 75.86% and 82.56%. The top three divisions in tertiary hospitals for external-care-seeking were surgical, obstetrics and gynecology, internal medicine. Based on the interview, admitting out-of-shanghai patients is conducive to the improvement of the technical level of hospitals, and to the enhancement of the utilization efficiency of health resource. However, the local residents may have less accessibility of high quality of medical service. The average expense of external-care-seeking is higher than that of local patients happened in the same level of hospitals. Conclusions: External-care-seeking will have a more far-reaching impact on the health care system in Shanghai; some interventions might be necessary, such as rationally allocating medical resources based on the estimates of external-care-seeking and establishing a medical service supervision mechanism.
Highlights
Background and RationaleAccording to the international literature review, the factors influencing healthcare mobility include culturalHow to cite this paper: Jin, C.L., Li, F., Wang, L.N., Hu, S.L. and Wang, C.Y. (2015) The Study on the Process and Impact of External-Care-Seeking Behavior in Shanghai
While in China medical resources of high quality are mainly concentrated in metropolitans, part of patients start to seek care in other cities to meet their health needs
External care seekers have brought positive effects for promoting the development of health care in Shanghai, increasing efficiency of medical services and improving the utilization of medical high technology. It was an upsetting issue for some reasons: local residents may have less access to local medical services, especially to tertiary hospitals and special medical services; external patients may have unreasonable high costs due to the absence of effective supervision and management in cross-region health insurance systems, which poses an impact on local medical resource allocation, service supervision and health insurance management
Summary
According to the international literature review, the factors influencing healthcare mobility include cultural. External care seekers have brought positive effects for promoting the development of health care in Shanghai, increasing efficiency of medical services and improving the utilization of medical high technology. It was an upsetting issue for some reasons: local residents may have less access to local medical services, especially to tertiary hospitals and special medical services; external patients may have unreasonable high costs due to the absence of effective supervision and management in cross-region health insurance systems, which poses an impact on local medical resource allocation, service supervision and health insurance management
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