The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan

Wen-Yi Chen Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung City, TaiwanCorrespondence: Wen-Yi ChenDepartment of Senior Citizen Service Management, National Taichung University of Science and Technology, 193 Sec 1, San-Min Road, Taich...

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Autor principal:	Chen WY
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	connectedness network analysis connectedness index referral behavior referral policy national health insurance Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/75238206ee29432eb249f132aba78c97
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spelling	oai:doaj.org-article:75238206ee29432eb249f132aba78c972021-11-21T19:08:51ZThe Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan1179-1594https://doaj.org/article/75238206ee29432eb249f132aba78c972021-11-01T00:00:00Zhttps://www.dovepress.com/the-effect-of-interdependences-of-referral-behaviors-on-the-quality-of-peer-reviewed-fulltext-article-RMHPhttps://doaj.org/toc/1179-1594Wen-Yi Chen Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung City, TaiwanCorrespondence: Wen-Yi ChenDepartment of Senior Citizen Service Management, National Taichung University of Science and Technology, 193 Sec 1, San-Min Road, Taichung City, 40343, TaiwanTel +886 4 22196932Fax +886 4 22196811Email chenwen@nutc.edu.twPurpose: The purpose of this study is to investigate the effect of interdependences of healthcare providers’ referral behaviors on the quality of ambulatory care. The significance of this study is to address the concern regarding the low quality of ambulatory care due to the lack of a compulsory referral system under Taiwan’s National Health Insurance system.Methods: We applied the dynamic connectedness network analysis to estimate the total connectedness index of the referral behavior network, which was separated into the horizontal and vertical referral behavior components in order to measure the interdependences of horizontal and vertical referral behaviors across hospitals and local clinics, respectively.Results: Our results suggest that the interdependences of referral behaviors increase the quality of ambulatory care. The harmful effect on the quality of ambulatory care from the interdependences of horizontal referral behaviors within the local clinics sector is more significant than that from the interdependences of horizontal referral behaviors within the hospital sector, and the negative effect on the overall and chronic composite measures of avoidable hospital admissions from the interdependences of vertical behaviors associated with local clinics is more substantial than that from the interdependences of vertical behaviors within the hospital sector.Conclusion: These results not only highlight the significance of care collaboration between local clinics and hospitals to restrain avoidable hospital admissions of chronic diseases for a better overall quality of ambulatory care, but they also suggest that the surveillance system established for the quality of ambulatory care under the global budget payment scheme for the local clinics sector should target ambulatory care for patients with acute conditions.Keywords: connectedness network analysis, connectedness index, referral behavior, referral policy, National Health InsuranceChen WYDove Medical Pressarticleconnectedness network analysisconnectedness indexreferral behaviorreferral policynational health insurancePublic aspects of medicineRA1-1270ENRisk Management and Healthcare Policy, Vol Volume 14, Pp 4709-4721 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	connectedness network analysis connectedness index referral behavior referral policy national health insurance Public aspects of medicine RA1-1270
spellingShingle	connectedness network analysis connectedness index referral behavior referral policy national health insurance Public aspects of medicine RA1-1270 Chen WY The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan
description	Wen-Yi Chen Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung City, TaiwanCorrespondence: Wen-Yi ChenDepartment of Senior Citizen Service Management, National Taichung University of Science and Technology, 193 Sec 1, San-Min Road, Taichung City, 40343, TaiwanTel +886 4 22196932Fax +886 4 22196811Email chenwen@nutc.edu.twPurpose: The purpose of this study is to investigate the effect of interdependences of healthcare providers’ referral behaviors on the quality of ambulatory care. The significance of this study is to address the concern regarding the low quality of ambulatory care due to the lack of a compulsory referral system under Taiwan’s National Health Insurance system.Methods: We applied the dynamic connectedness network analysis to estimate the total connectedness index of the referral behavior network, which was separated into the horizontal and vertical referral behavior components in order to measure the interdependences of horizontal and vertical referral behaviors across hospitals and local clinics, respectively.Results: Our results suggest that the interdependences of referral behaviors increase the quality of ambulatory care. The harmful effect on the quality of ambulatory care from the interdependences of horizontal referral behaviors within the local clinics sector is more significant than that from the interdependences of horizontal referral behaviors within the hospital sector, and the negative effect on the overall and chronic composite measures of avoidable hospital admissions from the interdependences of vertical behaviors associated with local clinics is more substantial than that from the interdependences of vertical behaviors within the hospital sector.Conclusion: These results not only highlight the significance of care collaboration between local clinics and hospitals to restrain avoidable hospital admissions of chronic diseases for a better overall quality of ambulatory care, but they also suggest that the surveillance system established for the quality of ambulatory care under the global budget payment scheme for the local clinics sector should target ambulatory care for patients with acute conditions.Keywords: connectedness network analysis, connectedness index, referral behavior, referral policy, National Health Insurance
format	article
author	Chen WY
author_facet	Chen WY
author_sort	Chen WY
title	The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan
title_short	The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan
title_full	The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan
title_fullStr	The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan
title_full_unstemmed	The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan
title_sort	effect of interdependences of referral behaviors on the quality of ambulatory care: evidence from taiwan
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/75238206ee29432eb249f132aba78c97
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The Effect of Interdependences of Referral Behaviors on the Quality of Ambulatory Care: Evidence from Taiwan

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