{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:46:50Z","timestamp":1777902410038,"version":"3.51.4"},"reference-count":59,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2017,11,14]],"date-time":"2017-11-14T00:00:00Z","timestamp":1510617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71233008"],"award-info":[{"award-number":["71233008"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71303248"],"award-info":[{"award-number":["71303248"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71673291"],"award-info":[{"award-number":["71673291"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["91244005"],"award-info":[{"award-number":["91244005"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SIMULATION"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Two-way referrals between hospitals and community healthcare systems (CHSs) are important for optimizing the distribution of medical resources and enabling resource sharing, but referrals are always from CHSs to hospitals. A referral from the hospital to the community is rare in China; this has a highly negative impact on the long-term development of the Chinese health services. The aim of this study was to address influence factors in hospital\u2013community referrals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We constructed a system dynamics model to address the problem of the two-way referral between hospitals and CHSs and identified potential countermeasures and possible solutions. The Vensim DSS program was used to construct a system dynamics model to represent the problem through model description, causal loop diagrams, and stock and flow diagrams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The model was used to perform intervention experiments, in which the influence on all the sectors of referrals could be observed by changing the system parameters. The experimental results showed a greater difference in medical costs between hospitals and CHSs, more investments to CHSs, higher levels of medical insurance of CHSs, and more referrals from hospitals to CHSs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The system can widen the price gap between hospitals and CHSs, increase information flow, improve medical insurance level of CHSs, and elevate the current level of CHSs through enabling two-way referral between hospitals and CHSs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0037549717741349","type":"journal-article","created":{"date-parts":[[2017,11,14]],"date-time":"2017-11-14T09:20:35Z","timestamp":1510651235000},"page":"765-782","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Factors influencing two-way referral between hospitals and the community in China: A system dynamics simulation model"],"prefix":"10.1177","volume":"94","author":[{"given":"Meina","family":"Li","sequence":"first","affiliation":[{"name":"Second Military Medical University, College of Health Service, Institute of Military Health Management, CPLA, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Second Military Medical University, College of Health Service, Institute of Military Health Management, CPLA, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Lu","sequence":"additional","affiliation":[{"name":"Fourth Military Medical University, Graduate School, Xi\u2019an, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenya","family":"Yu","sequence":"additional","affiliation":[{"name":"Second Military Medical University, College of Health Service, Institute of Military Health Management, CPLA, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Nong","sequence":"additional","affiliation":[{"name":"Maternal and Child Service Center of Rizhao City, Rizhao, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lulu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Second Military Medical University, College of Health Service, Institute of Military Health Management, CPLA, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,11,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2013.10.005"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0206-4"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2014.03.019"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(97)00244-8"},{"key":"e_1_3_4_6_2","first-page":"207","article-title":"Implementation of best medical therapy for cardiovascular risk factors in vascular surgery patients treated in a tertiary referral regional unit","volume":"100","author":"McGrogan D","year":"2013","unstructured":"McGrogan D, Mark D, Lee B, et al. 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