Resource allocation for chronic diseases based on a patient willingness survey

Area of Science:

• Health economics
• Public health policy
• Healthcare management

Background:

• Patients with chronic diseases in China have unrestricted choice of medical institutions, leading to resource waste and increased costs.
• This freedom contributes to inefficient healthcare seeking behaviors and financial burdens on the medical system.

Purpose of the Study:

• To identify effective mechanisms for incentivizing chronic disease patients to utilize community health centers for referrals to tertiary hospitals.
• To estimate potential cost savings through various incentive strategies.

Main Methods:

• Survey research involving 1824 outpatients at nine tertiary hospitals in Shanghai.
• Expert consultations and data simulation using the 2015 Shanghai outpatient database.
• Analysis of patient willingness to obtain referrals under different incentive scenarios.

Main Results:

• Only 48.4% of patients were willing to obtain referrals initially.
• Increasing registration fees, reducing medical insurance payment ratios, and publicizing/rating community health center quality increased willingness to 51.3%, 50.6%, and 65.41%, respectively.
• These mechanisms could save 361.67, 356.73, and 461.14 million yuan annually in Shanghai.

Conclusions:

• Referral systems for chronic disease patients can reduce overall medical expenses and conserve medical insurance funds.
• No single intervention is sufficient; integrated and comprehensive measures are required to effectively modify patient behavior and promote guided referrals.