Effectiveness analysis of referral system to Khon Kaen Hospital using CMI and other related factors

Abstract

This retrospective study aimed to 1) compare the AdjRW values to the CMI of each hospital level, and 2) study factors related to referral CMI during the year 2020-2022. Results indicate that during 2020-2022 there were a total of 23,986, 22,948, and 20,631 transfers respectively.  Of this, 5,323, 3,979, and 3,235 referred patients had AdjRW values below CMI standard criteria which constituted to 22.19%, 17.34% and 15.68% respectively.  Transfers below CMI standard from M1-F3 were 25.91%, 25.80%, 21.75%, 20.55%, and 18.03% in 2020,  20.47%, 22.28%, 16.12%, 15.90% and 13.77% in 2021 and 21.59%, 19.13%, 14.27%, 14.20% and 12.89% in 2022. Factors associated with AdjRW lower than CMI standard were 1) after-office hour transfers which accounted for 51.17%, 51.52% and 51.75%, 2) healthcare costs which were 46,236,507 baht, 38,504,117 baht, and 36,995,780 baht and 3) major diagnostic category (MDC) that had AdjRW below standard was Code 23 (Factors influencing…) for M1, M2 and F1 hospitals, Code 14 (Pregnancy, Childbirth and Puerperium) for F2 hospitals, and Code 12 (Male reproductive system) for F3 hospitals. M1 hospitals had medical specialists in almost every area while M2, F1, F2 and F3 had specialists only in some area.  As a results, hospitals at each level should learn and comply with the CMI through the effective information technology system and encourage competency enhancement according to their hospital levels.