Analysis of the Necessity of Assists Clinic Examinations of Multi-institutional Readmission Inpatients in Rural China: township-county hospitals

Background: There is always the matter of improper utilization of clinical examinations for multi-institutional readmission patients in rural areas, which is harm to the continuity of care as well as increases the economic burden of disease. ObjectiveTo figure out the necessity of utilization of X-ray and ECG and analyze the time interval and necessity of repeated assist examination among patients from multi-institutional readmission inpatients: township—county hospitals. MethodsSelect 3 kinds of respiratory system diseases and 2 kinds of cerebral vascular system diseases as target diseases. Screen the database of the New Rural Cooperative Medical System by using Excel 2010 to get the readmission inpatient list of 7 counties. Match the medical records extracted based on the readmission inpatient list, we got 630 sets of medical records. Then made descriptive statistics analysis and relativity analysis on X-ray and ECG by using SPSS 20.0. ResultsThe utilization of X-ray and ECG in county level health institutions (73.2%, 72.4%) are more than that in township level health institutions (53.8%, 61.0%). The average time interval of X-ray examinations is 10.79 days (4.1% happened in the one day), and the average time interval of ECG examinations is 9.93 days (The average time interval of X-ray examinations is 5.7%). 24.05% of examinations at township level are completely useless, while 11.08% of examinations at the county level check are not needed. Discussion: The utilization of clinical examinations for multi-institutional readmission patients is improper, and there are a large number of unnecessary repeated clinical examinations. The reason is that repeated clinical examinations are not paid enough attention to; it is difficult to transfer examination results; examination results from township level institutions are not actively used by county level doctors; mutual recognition of test results has not yet realized. Conclusions: Repeated clinical examinations are general for multi-institutional readmission patients, which calls for cooperation of multi-level institutions. Lesson learned: Standardsare neededfor clinical examinations and medical information should be transferred effectively to realize the mutual recognition of test results. Limitations: Medical records in village institutions are not taken good care of, which leads to sample size reduction. Suggestions for future research: The management level of medical records should be raised in primary medical institutions