ArticleBMC public health2024
Network characteristics of referrals for chronic disease patients: results from hierarchical medical reform in Shenzhen, China.
Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Exploring service demands of community-embedded elderly care based on the Kano model: a cross-sectional study in Hefei, China.BMC geriatrics · 2026Article
- Two-Way Referrals in Chinese Medical Consortia Under the Framework of Hierarchical Diagnosis and Treatment: Progress and Challenges.Journal of evidence-based medicine · 2025Review
- The cream-skimming behaviors of tertiary hospitals under medical alliances: evidence from China.International journal for equity in health · 2025Article
- Patient-centered medical home and the quality of primary care: survey study with patients and administrators of community healthcare centers in Shanghai, China.BMC primary care · 2025Article
- The mismatch in hierarchical diagnosis and treatment construction and related reasons: a qualitative analysis from ZX City, Hubei Province.Frontiers in public health · 2025Article
- Strengthening workforce resilience to sustain community health services during crises: evidence from Chinese general practitioners.Frontiers in public health · 2025Article
- Characteristics of pediatric e-referrals through SMARC system: a two-year national analysis.Frontiers in medicine · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe Chinese government has introduced a series of hierarchical medical policies to ensure continuity of care, but referrals remain difficult to implement effectively. This study aimed to evaluate the chronic disease referral network and explore the problems associated with the specific implementation of referrals.
methodsThis study was a repeated cross-sectional study of monthly data collected between August 2017 and December 2023 in Luohu district, Shenzhen, China. Social network analysis was used to construct a referral network for chronic disease patients. Density, degree centrality, and betweenness centrality were calculated to assess the relationships and status among different levels of care and their trends.
resultsOver seven years, 104,682 chronic disease patients were referred, with a predominance of downward referrals. The number of upward referrals (Z = 2.5776, P
conclusionsThe referral network has a vertical flow pattern conducive to the division of labour, cooperation, and resource integration of medical institutions in the region, and a hierarchical medical order is taking shape. However, poor communication between secondary hospitals and other institutions, high demand for data informatisation, and the gap between private and public PCFs may hinder further progress.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.