The Study on the Process and Impact of External-Care-Seeking Behavior in Shanghai


Objectives: To evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methods: Obtaining data from regular reports from public medical institutions in Shanghai, comparing patients who seek doctors from out-of-Shanghai residence and local patients with insurance in terms of the quantity of service, types of diseases, medical expenses, etc. Results: External-care-seeking has a large quantity, especially in hospitalization. In 2012, the number of discharged population from out-of-Shanghai accounted for 22.74% of the total discharged number, the proportion even higher than 30% in tertiary hospitals. Tertiary hospitals have a significant attraction effect, concentrating 59.42% of the outpatient and emergency visits and 71.82% of the amount of hospitalization, with corresponding cost of 75.86% and 82.56%. The top three divisions in tertiary hospitals for external-care-seeking were surgical, obstetrics and gynecology, internal medicine. Based on the interview, admitting out-of-shanghai patients is conducive to the improvement of the technical level of hospitals, and to the enhancement of the utilization efficiency of health resource. However, the local residents may have less accessibility of high quality of medical service. The average expense of external-care-seeking is higher than that of local patients happened in the same level of hospitals. Conclusions: External-care-seeking will have a more far-reaching impact on the health care system in Shanghai; some interventions might be necessary, such as rationally allocating medical resources based on the estimates of external-care-seeking and establishing a medical service supervision mechanism.

Share and Cite:

Jin, C. , Li, F. , Wang, L. , Hu, S. and Wang, C. (2015) The Study on the Process and Impact of External-Care-Seeking Behavior in Shanghai. Open Journal of Preventive Medicine, 5, 103-110. doi: 10.4236/ojpm.2015.53012.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Yip, W.C.-M., Hsiao, W.C., Chen, W., et al. (2012) Early Appraisal of China’s Huge and Complex Health-Care Reforms. Lancet, 379, 833-842.
[2] Weisz, G. (2011) Historical Reflections on Medical Travel. Anthropology & Medicine, 18, 137-144.
[3] Horton, S. and Cole, S. (2011) Medical Returns: Seeking Health Care in Mexico. Social Science & Medicine, 72, 1846-1852.
[4] Hazarika, I. (2010) Medical Tourism: Its Potential Impact on the Health Workforce and Health Systems in India. Health Policy and Planning, 25, 248-251.
[5] Wu, T. and Heng, D.Q. (2010) The Initial Emergence of “One Core and Nine Lines” Layout in Yangtze River Delta. Shanghai Securities News.
[6] Li, S.C. (2010) Joint Efforts Are Called for in the Whole Management and Service System for Cross-Region Healthcare. China Health Insurance, 12-14.
[7] Li, F., Jin, C.L. and Wang, L.N. (2012) The Study on External-Care-Seeking Status in Shanghai and its Impact on Health Care System. Chinese Health Economics, 42-45.
[8] Shanghai Municipal Development and Reform Committee.
[9] Jiang, X. (2009) Cross-Region Medical Treatment: Cost Control Is the Key. Chinese Social Security, 73.
[10] Zhang, M. and Liu, Q. (2008) Cross-Region Medical Treatment: From Regional Cooperation to National Co-Ordinating Collaboration. China Social Insurance, 74-75.
[11] Hu, S.L., Ding, H.S. and Wang, X.J. (2011) Investigation on Shanghai Health Insurance and Health Joint Problems. Special Report on Advances in Health Policy Research, 1-8.
[12] Meng, Q.M. (2011) Cross-Region Medical Treatment Collaboration in Pan Northwest Region. Chinese Medical Insurance, 70.
[13] Cao, A.H., Bai, Z.Q. and Han, Y.W. (2009) An Assumption on the Establishment of Cross-Region Settlement of Medical Treatment with Pan-Pearl River Delta. Chinese Health Economics, 56-57.
[14] Liu, W.W. and Jia, H.B. (2011) Cross-Region Medical Treatment Management of Basic Medical Insurance. Chinese Health Economics, 15-17.

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.