Shams Asadollah, Ashrafi-rizzi Hassan, Afrough Saeed, Javadi Marzieh, Shams Amin
Health Management and Economic Research Center. Isfahan University of Medical Sciences , Isfahan, Iran.
Acta Inform Med. 2013 Mar;21(1):51-5. doi: 10.5455/aim.2012.21.51-55.
Cutting back on the staff and equipment and also reduction of costs and devices, balanced distribution of resources for optimal use and prevention of unreasonable costs for patients are some advantages of the fulfillment of referral system process. Accordingly the purpose of the present study is to determine factors affecting the fulfillment of referral system process from the viewpoints of clients of Isfahan's public hospitals so that health system could benefit its advantages.
The research is a descriptive-analytic survey and the population consisted of clients referring to public hospitals of Isfahan Province. Hospitals conforming to health network in cities of Falavarjan, ShahinShahr, Shahreza, Naein and some public hospitals of Isfahan city were selected for study. Cluster sampling was applied and at the end 400 subjects were selected by simple random sampling.
Results showed that awareness and satisfaction in urban communities and motivation in rural are of higher levels. Regarding insurance status, those covered by Social Security have the most referrals to all levels and those covered by Health Service Insurance have more referral to the first level. The mean score of awareness of clients about referral system among the hospitals investigated shows a significant difference (p-value≤0.05).
Results indicate that from the viewpoints of urban clients, the rate of the awareness of and satisfaction with the way of offering health services at primary levels and from that of rural clients motivation affect the fulfillment of referral system process. Therefore improvement of these factors could make the system more efficient.
精简人员和设备、降低成本及减少医疗设备、合理分配资源以实现最优利用并避免患者承担不合理费用，是实施转诊系统流程的一些优势。因此，本研究的目的是从伊斯法罕公立医院患者的角度确定影响转诊系统流程实施的因素，以便卫生系统能够从中受益。
本研究为描述性分析调查，研究对象为前往伊斯法罕省公立医院就诊的患者。研究选取了法勒瓦扬、沙欣沙赫尔、沙赫雷扎、奈因等城市符合卫生网络标准的医院以及伊斯法罕市的一些公立医院。采用整群抽样法，最后通过简单随机抽样选取了400名研究对象。
结果显示，城市社区的认知度和满意度以及农村地区的积极性较高。在保险状况方面，参加社会保障的人群向各级转诊的次数最多，参加健康服务保险的人群向一级转诊的次数更多。在所调查的医院中，患者对转诊系统的认知度平均得分存在显著差异（p值≤0.05）。
结果表明，从城市患者的角度来看，基层卫生服务提供方式的认知度和满意度以及农村患者的积极性影响转诊系统流程的实施。因此，改善这些因素可提高系统效率。
