A downward health care referral system in Bangladesh through diabetic association branches

Ali, Azin; Lahiry, Suman; Khan, Asif; Ali, L; Habib, Sara

doi:10.1016/s0168-8227(00)81386-8

Cited by 2 publications

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“…40 41 Considering the characteristics of policymaking and long-term development process of CHSs, it is impossible to thoroughly conduct the community first treatment system and downward referral system, and improve the development of CHSs in the short term. Given the flexibility of doctors' and patients' practices and attitudes towards referral, the low rate of downward referral and its advantage of reducing medical costs, 42 this study focused on the practices and attitudes of doctors and patients to downward referral. Therefore, the aim of this study was to explore whether doctors' and patients' practices and attitudes to downward referral influence their willingness for referral from hospitals to CHSs, and the relationship between downward referral and sociodemographic characteristics.…”

Section: Introductionmentioning

confidence: 99%

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Nong

et al. 2017

BMJ Open

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ObjectivesIn China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics.MethodsDoctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling. The questionnaire surveyed their sociodemographic characteristics, attitudes towards CHSs and hospitals, understanding of downward referral, recognition of the community first treatment system, and downward referral practices and willingness. Descriptive statistics, χ2 test and stepwise logistic regression analysis were employed for statistical analysis.ResultsOnly 20.8% (161/773) of doctors were willing to accept downward referrals, although this proportion was higher among patients (37.6%, 326/866). Doctors' willingness was influenced by education, understanding of downward referral, and perception of health resources in hospitals. Patients' willingness was influenced by marital status, economic factors and recognition of the community first treatment system. Well-educated doctors who do not consider downward referral would increase their workloads and those with a more comprehensive understanding of hospitals and downward referral process were more likely to make a downward referral decision. Single-injury patients fully recognising the community first treatment system were more willing to accept downward referral. Patients' willingness was significantly increased if downward referral was cost-saving. A better medical insurance system was another key factor for patients to accept downward referral decisions, especially for the floating population.ConclusionsTo increase the rate of downward referral, the Chinese government should optimise the current referral system and conduct universal publicity for downward referral. Doctors and patients should promote understandings of downward referral. Hospitals should realise the necessity of downward referral, effectively reduce workloads and provide continuing education for doctors. Increasing monetary reimbursement is urgent, as is improving the medical insurance system.

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Section: Introductionmentioning

confidence: 99%

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Nong

et al. 2017

BMJ Open

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“…Demographic transition, combined with urbanization and industrialization, has resulted in drastic changes in lifestyles globally. Consequently, lifestyle-related diseases like diabetes have emerged as major public health problems in the developing countries [ 3 - 5 ]. Three-quarters of persons with diabetes live in low- and middle-income countries [ 2 ] where more than 80% of diabetes related deaths occur.…”

Section: Introductionmentioning

confidence: 99%

Social and economic impact of diabetics in Bangladesh: protocol for a case–control study

Islam¹,

Lechner

Ferrari

et al. 2013

BMC Public Health

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BackgroundDiabetes affects both individuals and their families and has an impact on economic and social development of a country. Information on the availability, cost, and quality of medical care for diabetes is mostly not available for many low- and middle-income countries including Bangladesh. Complications from diabetes, which can be devastating, could largely be prevented by wider use of several inexpensive generic medicines, simple tests and monitoring and can be a cost saving intervention. This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetes in Bangladesh and propose clear recommendations for improving prevention and management of diabetes. The objectives of the study are:1) To study the association between diabetes and other health problems and its social impacts2) To estimate the economic impact of diabetes including total direct and indirect costs3) To measure the impact of diabetes on quality of life among diabetes patients in Bangladesh4) To study the impact of diabetes on the health care systemMethodsThis is a case–control study comparing cases with type 2 diabetes to controls without diabetes matched on age, sex and place of residence. 564 cases and 564 controls will be selected from the outpatient department of a tertiary hospital in Dhaka, Bangladesh. Data on socioeconomic status, health utility index, direct and indirect costs for diabetes, medication adherence, quality of life, treatment satisfaction, diet, physical activity, mental state examination, weight, height, hip and waist circumference, blood pressure, pulse, medication history, laboratory data and physical examination will be conducted.Outcome measures: The primary outcome measures will be association between diabetes and other health problems, cost of diabetes, impact of diabetes on quality of life and secondary outcome measures are impact of diabetes on healthcare systems in Bangladesh.DiscussionThis study will provide an in-depth and comprehensive picture of social and economic impacts of diabetics in Bangladesh and propose clear recommendations for improving prevention and management of diabetics. It will help to develop programs and policies for better management of Diabetics and cost effective strategies in Bangladesh context.

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A downward health care referral system in Bangladesh through diabetic association branches

Cited by 2 publications

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Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Social and economic impact of diabetics in Bangladesh: protocol for a case–control study

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