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APHA Scientific Session and Event Listing

lai Chao ying, Department of Management, Tri-Services General Hospital, PO Box 90055 Nei-Hu, Taipei, Taiwan, 886-2-87927982, liachao@ms13.url.com.tw

The purpose of the study is to determine the willingness of cardiac patients for referral treatment from medical centers to affiliated community clinics with same doctors and prescription drugs, as a reference for future referral policy. The research samples chronic patients with refilling cards in July, 2004 from the database of a medical center. Through purposive sampling, we select 586 cardiac patients whose visits to doctors in the previous year are fewer than 52 times and average medical cost per visit is more than NT$ 1,500. The survey is conducted through telephone interview, with 369 valid questionnaires (62.7% response rate) The average age of the respondents is 64.62 years. There are more male respondents (59.2%) than female ones (40.8%). Willingness of the patients to be referred are mainly influenced by the following five variants: special treatments accompanied by referral, the traffic to original medical center, the traffic to referred clinics, satisfaction with the medical staff of the original hospital, and whether the schedules of doctors at the referred clinics fits those of patients.Overall, the respondents willing to be referred (48.7%) are slightly fewer than those unwilling (51.3%), with no statistical significance. The 5 main considerations for the willing are: same doctors, convenient traffic, less waiting time, less medical cost and flexibility of the treatment schedule. For those unwilling the 5 main considerations are: inconvenient traffic, the habit of returning to original hospitals, the need of time for consideration, special privileges in administrative procedures, and the better facilities at original hospitals. The study uses telephone interview to determine the similarities and differences between the reasons why patients accept referral, and why they chose a certain medical institution for treatment. Most of the respondents value convenience of traffic, loyalty to doctors and accustomed medical institutions. We recommend hospitals to build up strategic alliances and cooperative system with local community clinics. Success rate for referral increases only when patients are able to seek medical treatment within the community, and when their feelings are well taken care of.

Learning Objectives:

• The purpose of the study is to determine the willingness of cardiac patients for referral treatment from medical centers to affiliated community clinics with same doctors and prescription drugs, as a reference for future referral policy.

Keywords: Chronic Illness, Community

Presenting author's disclosure statement:

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