Predictors of referral behaviour and intention amongst physicians in a medical consortium based on the theory of planned behaviour

A cross-sectional study in China

Bibliographic Data

ID22073630
AuthorsDongbao Zhao (0000-0003-4404-8113, Sun Yat-sen University), Shengliang Chen (Sun Yat-sen University), Sihui Jin (Sun Yat-sen University), Lijin Chen (0009-0005-3070-8936, Sun Yat-sen University), Caiyun Zheng (0000-0002-3977-7138, Sun Yat-sen University), Xin Wang (0000-0003-2833-6940, Sun Yat-sen University, corresponding author), Yixiang Huang (0000-0003-3370-148X, Sun Yat-sen University, corresponding author)
Year2023
Volume11
Pages1159207-1159207
Publication date2023-08-16
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2023.1159207
PMID37655287
OpenAlexW4385954039
LanguageEN
Citations received2
References cited49

Introduction To promote patients’ referral across healthcare institutions and integrated care delivery, we identified predictors of physicians’ behaviour and intention to refer patients in a county medical consortium in China on the basis of the theory of planned behaviour (TPB). Methods This census-based cross-sectional study was conducted in Yangxi Hospital Group (YHG). All physicians in county hospitals and township health centres were invited to participate. Structural equation modelling was employed to analyse the relationships between referral intention and behaviour and other TPB variables in the group of whole participants and in sub-groups. Results In total, 330 physicians participated in this study. One-third of participants were general practitioners, and half of them were from county hospitals. Referral behaviour of females ( χ 2 = 20.372, p < 0.001), who had lower education levels ( χ 2 = 17.859, p = 0.001), lower professional title ( χ 2 = 14.963, p = 0.005), and lower monthly salary ( χ 2 = 33.753, p < 0.001) were less frequent than the others. Among them, 116 (35.2%), 108 (32.7%), and 106 (32.1%) respondents reported that they had never referred patients, had referred patients 1–9 times, and had referred patients over 10 times during the past 3 months, respectively. The mean score of referral intention was 4.23/5 (SD = 0.71). In the model with all participants, a stronger referral intention ( β = 0.218, 95% CI = 0.080–0.356) was associated with more frequent referral behaviour. The subjective norm ( β = 0.703, 95% CI = 0.590–0.817) was the strongest predictor of physicians’ referral intention, followed by perceived behavioural control ( β = 0.234, 95% CI = 0.090–0.378). Mediated by referral intention, subjective norms ( β = 0.153, p < 0.01) and perceived behavioural control ( β = 0.190, p < 0.01) had significant indirect effects on physicians’ referral behaviour. The model with participants in county hospitals showed similar results to the model with all participants. Meanwhile, in the model with participants in township health centres, there were no significant associations between referral behaviour and other TPB constructs. Conclusion Physicians’ referral behaviour was influenced by intention, subjective norms, and perceived behavioural control in Chinese county hospitals

Cross-sectional study · Family medicine · Pathology · Referral · Theory of planned behavior · Computer Science · Medicine · Patient Satisfaction in Healthcare · Patient-Provider Communication in Healthcare · Pharmaceutical industry and healthcare · Psychology

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