Qualitative Analysis of the Reasons for Cross-provincial Referral and Transfer of Patients in County Areas from the Perspective of Doctors
Cheng Fei'er
Cui Lijuan
He Jingran
Tian Guomei
Gao Kai
Liu Jia
Xu Jinpeng
Deng Fangmin
Chen Fangting
Jiang Xinyan
Zuo Xinhui
Kang Zheng
Abstract：Objective To analyze the reasons for inter-provincial patient referral in Heilongjiang Province's counties from a doctor's perspective,and to provide theoretical support for enhancing primary healthcare capacity,improving medical insurance fund efficiency,and promoting the implementation of the hierarchical diagnosis and treatment system.Methods Using purposive sampling,a semi-structured in-depth interview was conducted with 31 doctors from county-level hospitals.Based on grounded theory used NVivo 1 2 Plus software for word frequency analysis and three-level coding to build a theoretical model of the reasons for inter-provincial patient referrals.Results Through coding analysis,1 7 subcategories and 7 overarching categories were identified,overarching categories includes medical resource levels,economic factors,social relationships,external influences,individual characteristics,medical cognition,service experience,and institutional environment.Central contributing factors included the obsolescence of medical equipment and the inadequate diagnostic and therapeutic capacities of county-level healthcare institutions.Conclusion The inter-provincial referral behavior of patients is influenced by multiple factors.It is recommended to strengthen the construction of grassroots specialties,enhance the service capacity of county-level hospitals,improve the differentiated reimbursement mechanism of medical insurance,strengthen doctor-patient communication,promote rational medical treatment,and promote the effective implementation of hierarchical diagnosis and treatment.
Keywords：cross-provincial referral and transfercounty-level patientsdoctor
Publication Date：2026-01-05
Online Publishing Date：2026-01-17(First online date of this platform, not the publication date of the document)
Pages：6( 74-79 )