Occupational Medicine & Health Affairs
Open Access

Abstract

Statement of the Problem: As a regional medical center in China, medical institutions in Shanghai take a lot of patients from out-ofShanghai. This external-care-seeking behavior places big and increasing burden on Shanghai�s health care system, considering limited medical resource for residents and escalating medical expenses. The purposes of this study are to evaluate the impact of externalcare-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 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-careseeking and establishing a medical service supervision mechanism. Recommendations are made for regulating external-care-seeking.

Biography

Chunlin Jin is a Professor of Tokyo University, Executive Deputy Director of SHDRC, Director of Shanghai Medical Information Center and Director of Shanghai Population and Development Research Center. His main research areas are health economics related administrative research and hospital management. He has been the Primary Investigator of more than 40 research projects, published over 160 papers, 70 of which as the first author. His research findings have won the Bronze Prize of Shanghai Science and Technology Progress, Silver Prize of Shanghai Municipal Government Decision-Making Advisory, Bronze Prize of China Hospital Association for Science and Technology Innovation, Bronze Prize of Shanghai Medical Science and Technology Award and Silver Prize of East China Science and Technology Information Achievements, and Award of Excellent Outcomes in Chinese Health Economics Association for many times.