Abstract for: A two-way referral between hospitals and community health systems in China: a system dynamics simulation model

Two-way referral between hospitals and community health systems is important for Optimizing the distribution of medical resources and enabling resource sharing, but referrals are almost from community to hospital and rarely the referral from hospital to community in China, which has a highly negative impact on the long-term development of the Chinese health service. We constructed a system dynamics model to address the problem of the one-way referral between hospitals and community health systems, and we suggest countermeasures and possible solutions. The program Vensim DSS was used to construct a system dynamics model to represent the problem follow the steps of model description, causal loop diagrams, stock-flow diagrams, and model validation. The model was used to perform intervention experiments, where the influence on all the sectors of referrals could be observed by changing the system parameters. The experimental results show that the greater difference between hospital medical prices and community medical prices, and the more input to community, the more referrals from hospitals to communities. So widen the price gap between hospitals and communities and increase input to improve community health is effective to enable two-way referral between hospitals and communities.