Table 1.
Doctors' sociodemographic characteristics and practices and attitudes towards downward referral
| Category | N (%) | Willingness of downward referral |
χ2‡ | p Value§ | |
|---|---|---|---|---|---|
| Yes (A*, T†) | No (A*, T†) | ||||
| Part I: sociodemographic characteristics | |||||
| Gender | 0.077 | 0.781 | |||
| Male | 430 (55.6) | 88 (89.6) | 342 (340.4) | ||
| Female | 343 (44.4) | 73 (71.4) | 270 (271.6) | ||
| Age | 2.836 | 0.418 | |||
| 20–29 | 139 (18.0) | 34 (29.0) | 105 (110.1) | ||
| 30–39 | 404 (52.3) | 85 (84.1) | 319 (319.9) | ||
| 40–49 | 182 (23.5) | 31 (37.9) | 151 (144.1) | ||
| 50–59 | 48 (6.2) | 11 (10.0) | 37 (38.0) | ||
| Level of education | 14.905 | 0.002 | |||
| Junior college degree | 7 (0.9) | 3 (1.5) | 4 (5.5) | ||
| Bachelor's degree | 211 (27.3) | 57 (43.9) | 154 (167.1) | ||
| Master's degree | 352 (45.5) | 75 (73.3) | 277 (278.7) | ||
| Doctor's degree | 203 (26.3) | 26 (42.3) | 177 (160.7) | ||
| Professional title | 4.122 | 0.249 | |||
| Junior and others | 263 (34.0) | 63 (54.8) | 200 (208.2) | ||
| Intermediate | 326 (42.2) | 68 (67.9) | 258 (258.1) | ||
| Associate senior | 133 (17.2) | 23 (27.7) | 110 (105.3) | ||
| Senior | 51 (6.6) | 7 (10.6) | 44 (40.4) | ||
| Department | 0.482 | 0.923 | |||
| Others | 95 (12.3) | 22 (19.8) | 73 (75.2) | ||
| Medical technology | 55 (7.1) | 12 (11.5) | 43 (43.5) | ||
| Internal medicine | 330 (42.7) | 66 (68.7) | 264 (261.3) | ||
| Surgery | 293 (37.9) | 61 (61.0) | 232 (232.0) | ||
| Part II: practices and attitudes towards downward referral | |||||
| Knowledge of healthcare services provided by CHSs¶ | 3.063 | 0.216 | |||
| Know nothing | 347 (44.9) | 71 (72.3) | 276 (274.7) | ||
| Partly know | 305 (39.5) | 71 (63.5) | 234 (241.5) | ||
| Fully understand | 121 (15.7) | 19 (25.2) | 102 (95.8) | ||
| Knowledge of downward referral process¶ | 8.016 | 0.018 | |||
| Know nothing | 364 (47.1) | 80 (75.8) | 284 (288.2) | ||
| Partly know | 275 (35.6) | 65 (57.3) | 210 (217.7) | ||
| Fully understand | 134 (17.3) | 16 (27.9) | 118 (106.1) | ||
| Knowledge of downward referral standards¶ | 0.788 | 0.674 | |||
| Know nothing | 366 (47.3) | 75 (76.1) | 291 (289.8) | ||
| Partly know | 273 (35.3) | 61 (56.9) | 212 (216.1) | ||
| Fully understand | 134 (17.3) | 25 (27.9) | 109 (106.1) | ||
| Understanding of the limitations of health resources in hospitals¶ | 25.341 | <0.0001 | |||
| Cannot understand | 15 (1.9) | 10 (3.1) | 5 (11.9) | ||
| Understand a little | 47 (6.1) | 10 (9.8) | 37 (37.2) | ||
| Moderate | 230 (29.8) | 49 (47.9) | 181 (182.1) | ||
| Partly understand | 268 (34.7) | 41 (55.8) | 227 (212.2) | ||
| Fully understand | 213 (27.6) | 51 (44.4) | 162 (168.6) | ||
| Attitudes towards workloads affected by downward referral¶ | 22.247 | <0.0001 | |||
| Does not increase workloads | 481 (62.2) | 126 (100.2) | 355 (380.8) | ||
| Increase workloads | 292 (37.8) | 35 (60.8) | 257 (231.2) | ||
*A is the actual frequency in χ2 test.
†T is the theoretical frequency in χ2 test.
‡The χ2 is the test statistic of χ2 test.
§p Value<0.05 is considered statistically significant.
¶The judgement on different aspects of doctors’ attitudes towards downward referral was determined according to the degree (from the most negative option to the most positive option) of doctors’ knowledge, understanding and perception.
CHS, community health system.