ChunlinJin
Director of Shanghai Medical Information Center, and Director of Shanghai
Title: The Study on the Process and Impact of External-Care-Seeking Behavior in Shanghai
Biography
Biography: ChunlinJin
Abstract
Statement of the Problem: As a regional medical center in China, medical institutions in Shanghai take a lot of patients from out-of-Shanghai. This external-care-seeking behavior places big and increasing burden on Shanghai’s health care system, considering limited medical resource for local residents and escalating medical expenses. The purposes of this study are to evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methodology & Theoretical Orientation: The data was obtained from regular reports of public medical institutions in Shanghai, and patients who seek doctors from out-of-Shanghai residence and local patients were compared in terms of the quantity of service, types of diseases, medical expenses, etc. Findings: On one hand, 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 was even higher than 30% in tertiary hospitals. Tertiary hospitals had 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. On the other hand, out-of-shanghai patients are conducive to improvement of medical skills the efficiency of health resource. However, the local residents may have less accessibility of high quality of medical service. External-care-seeking will have a more far-reaching impact on the health care system in Shanghai, some interventions should be necessary, including rationally allocating medical resources based on the estimates of external-care-seeking and establishing a medical service supervision mechanism.
Recommendations are made for regulating external-care-seeking.