Implementation and influencing factors of inter-hospital mutual recognition of medical examination results under hierarchical diagnosis and treatment policy

  Objective  To examine the implementation of inter-hospital mutual recognition of medical examination results (IH-MR-MER) and its influencing factors and to provide references for governmental agencies' policy making.

  Methods  We conducted an online or on-site questionnaire survey among 551 adult patients recruited with convenient sampling in 30 provinces across China between February and April 2018.

  Results  Of all the participants, 47.69% (248) reported not being aware of IH-MR-MER and the ratio was significantly higher among the participants in economically less-developed regions than among those in developed regions (59.06% vs. 25.84%, P < 0.001); only 6.15% of the participants reported knowing completely about IH-MR-MER. Among all the participants, 70.96% (369) believed that IH-MR-MER could decrease medical examination cost and simplify examination procedures; the ratio was unsignificantly higher among the participants in economically less-developed regions than among those in developed regions (75.11% vs. 32.40%) but the ratio (34.54%) among the participants in pilot regions of comprehensive medical reform was similar to that among those in other regions (34.79%). The proportion of the participants considering repeated examination being unnecessary and both time- and money-consuming was significantly higher in economically less-developed regions than in the developed regions (19.20% vs. 10.00%, P = 0.042). There were 38.27% (199/520) and 22.12% (115/520) of the participants thought the variability of medical examination results and difference in accuracy of instruments for medical examination being the two major hindering factors for IH-MR-MER. More participants in pilot regions of comprehensive medical reform considered the variability of medical examination results as a major hindering factor for IH-MR-MER than the participants in other regions (42.56% vs. 33.79%, P < 0.001).

  Conclusion  The implementation of inter-hospital mutual recognition of medical examination result policy is generally good but efficient measures should be adopted to promote the implementation of the policy.