探討影響台灣基層開業醫師轉診意願之因素

This study explored the experience, willingness, and satisfaction of primary care physicians with patient referrals, and the factors affecting the willingness to make patient referrals. Methods: The study used a systematic sample of 3,407 physicians selected from among 10,223 primary care physicians registered in the Department of Health in April 2002. A survey was mailed to collect applicable data. Five-hundred and twelve questionnaires were returned, for a response rate of 15.1%. The Statistical Package for the Social Sciences (SPSS) was used for data analysis. Results: Of the sample, 92.9% had experience of treating referrals, 63.3% were willing to treat referrals, and only 36.8% were satisfied with the current referral system. The biggest influence on physician willingness to refer patients was patient needs. Multiple logistic regression analysis showed that physicians who considered referrals could decrease malpractice lawsuits, that hospitals should adopt semi-open systems, and that government should implement a family physician system were more willing to refer patients than physicians without these attitudes. Meanwhile, physicians who feared referrals would result in the loss of patients, who thought receiving hospitals provided a quick response system for referral patients, and who saw appointed physicians as important factors were less likely to refer patients than other physicians without these attitudes. Conclusions: Of the sample group of physicians, only 63% were willing to refer patients. Therefore, this study recommends that the referral system should be improved.