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The Effect of the Referral System on the Accessibility of Healthcare Services: A Case Study of the Wuhan Metropolitan Development Zone

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  • Ying Chen

    (College of Public Administration, Huazhong University of Science and Technology, Wuhan 430074, China)

  • Jiale Wu

    (College of Public Administration, Huazhong University of Science and Technology, Wuhan 430074, China)

Abstract

The geographical accessibility of public healthcare institutions is the key factor affecting the equity of healthcare services. Based on the hierarchical medical system and referral system in China, we analyzed the referral accessibility of hospitals in the Wuhan Metropolitan Development Zone. Before the implementation of the referral system, only 7.91% of the total communities met the accessibility standard for secondary and tertiary hospitals, which meant that there was significant inequality in high-level healthcare. Moreover, 5.4% of the total communities did not meet the accessibility standard for primary hospitals, which meant that there were insufficient primary hospitals. After the implementation of the referral system, the proportions of communities meeting the accessibility standards for the first-stage referral, second-stage referral and cross-level referral were 92.6%, 99.9% and 98.3%, respectively. The results show that the referral system has improved the accessibility of healthcare, but it has not completely solved healthcare inequality. The first-stage referral accessibility of healthcare services in the northern, western and eastern groups does not meet the accessibility standard, which is due to the inefficient layout of secondary hospitals. The Wuhan government should construct secondary hospitals in these groups and primary hospitals in the central urban area and the southeastern, southern, western and eastern groups.

Suggested Citation

  • Ying Chen & Jiale Wu, 2022. "The Effect of the Referral System on the Accessibility of Healthcare Services: A Case Study of the Wuhan Metropolitan Development Zone," IJERPH, MDPI, vol. 19(16), pages 1-14, August.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:10441-:d:894441
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    1. Sharma, Gajanand & Patil, Gopal R., 2021. "Public transit accessibility approach to understand the equity for public healthcare services: A case study of Greater Mumbai," Journal of Transport Geography, Elsevier, vol. 94(C).
    2. Atella, Vincenzo & Brugiavini, Agar & Pace, Noemi, 2015. "The health care system reform in China: Effects on out-of-pocket expenses and saving," China Economic Review, Elsevier, vol. 34(C), pages 182-195.
    3. Arif, Imran, 2022. "Educational attainment, corruption, and migration: An empirical analysis from a gravity model," Economic Modelling, Elsevier, vol. 110(C).
    4. Gao, Pengjie & Lee, Chang & Murphy, Dermot, 2022. "Good for your fiscal health? The effect of the affordable care act on healthcare borrowing costs," Journal of Financial Economics, Elsevier, vol. 145(2), pages 464-488.
    5. Dominique Peeters & Isabelle Thomas, 2000. "Distance predicting functions and applied location-allocation models," Journal of Geographical Systems, Springer, vol. 2(2), pages 167-184, July.
    6. Neutens, Tijs, 2015. "Accessibility, equity and health care: review and research directions for transport geographers," Journal of Transport Geography, Elsevier, vol. 43(C), pages 14-27.
    7. Wang, Jian-Jun & Li, Zhong-Ping & Shi, Jim (Junmin) & Chang, Ai-Chih (Jasmine), 2021. "Hospital referral and capacity strategies in the two-tier healthcare systems," Omega, Elsevier, vol. 100(C).
    8. Kilinc, Mehmet Serdar & Milburn, Ashlea Bennett & Heier Stamm, Jessica L., 2017. "Measuring potential spatial accessibility of home healthcare services," Socio-Economic Planning Sciences, Elsevier, vol. 59(C), pages 13-25.
    9. Li, Hua & Yu, Wei, 2011. "Enhancing community system in China's recent health reform: An effort to improve equity in essential health care," Health Policy, Elsevier, vol. 99(2), pages 167-173, February.
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    2. Zhenbao Wang & Dong Liu & Shihao Li & Shuyue Liu & Huiqing Li & Ning Chen, 2023. "Analyzing the Impact of Decreasing Out-of-Vehicle Time of Public Transportation Travel on Accessibility to Tertiary Hospitals," Sustainability, MDPI, vol. 15(16), pages 1-20, August.

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