ArticlePatient preference and adherence2023
Capturing What Matters with Patients' Bypass Behavior? Evidence from a Cross-Sectional Study in China.
Article in Patient preference and adherence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Integrated Implementation Strategies to Promote the Use of AI-Assisted Diagnostic Software for Lung Nodule Screening in China: Process Evaluation Based on the RE-AIM Framework.JMIR formative research · 2026Article
- Factors Influencing Healthcare-Seeking Delay Among Chinese Residents: A Cross-Sectional Study.Patient preference and adherence · 2026Article
- Why the oldest old in China bypass primary care: culture, family, and health system limitations.International journal of qualitative studies on health and well-being · 2025Article
- From Habit to Justification: A Dual Process Theory Approach to Primary Care Bypassing in China.Health care analysis : HCA : journal of health philosophy and policy · 2025Article
- Article
- Behavioral Determinants of Hospital Selection in Urological Care: Evidence From China's Hierarchical Healthcare System.Risk management and healthcare policy · 2025Article
- Patient self-referral patterns in a developing country: characteristics, prevalence, and predictors.BMC health services research · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In China, bypassing is becoming increasingly prevalent. Such behavior, as going directly to upper-level health-care facilities without a primary care provider (PCP) referral when facing non-critical diseases, contrasts to "expanding the role of PCPs as the first-contact of care", may cause unneglectable damage to the healthcare system and people's physical health. Objective: To examine the relationship between patient experience in primary health-care clinics (PHCs) and their bypass behavior. Methods: A cross-sectional study was designed for data collection. From July 2021 to August 2021, we conducted a questionnaire survey nationally. Fifty-three Findings: A total of 928 qualified questionnaires were obtained. The first contact dimension (OR 0.961 [95% CI 0.934 to 0.988], P = 0.005) and continuity dimension (OR 1.034 [95% CI 1.000 to 1.068], P = 0.047) of patients' experience were significantly associated with patients' bypass behavior (P < 0.05). In addition, age (OR 1.072, [95% CI 1.015-1.132], P = 0.013) and gender (OR 2.044, [95% CI 1.139-3.670], P = 0.017) also made a statistically significant difference. Conclusion: Enhancement in patient experience at PHCs may help reduce their bypass behavior. Specifically, efforts are needed to improve primary care accessibility and utilization. The positive correlation between bypassing rates and continuity scores may require more attention on strengthening PCPs' technical quality besides the quality of interpersonal interactions.
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