Factors Affecting Back Referral of Type 2 Diabetes Mellitus Patient of National Health Insurance Members from the Hospital to the Primary Care Physicians

Increased number of National Health insurance members with type 2 diabetes mellitus (DM) may have an impact of cost of health care. Since 2010,Social Security Agency on Health implemented the Chronic Disease Management Programme (Prolanis), especially for type 2 DM disease. However, back referral from internal medicine specialist to primary care physician was not well implemented. This study aims to identify perceptions of internal medicine specialist and patients affecting implementation of back referral for patients with type 2 DM from the hospital to primary care physicians. A qualitative study was employed, using in-depth interviews, observation and focus group discussions. In-depth interviews were conducted with eight internal medicine spesialists in one hospitals in Jakarta Selatan City and two primary care physicians. Focus group discussions were conducted with four groups of patients with type 2 DM, and observation was made to describe the working environment at thehospital.

2型糖尿病（Type 2 Diabetes Mellitus, DM）参保人群规模的扩大，可能对医疗保健成本产生影响。自2010年起，卫生社会保障署推出了慢性病管理项目（Prolanis），重点针对2型糖尿病患者开展管理。然而，内科专科医师向基层全科医师的转回转诊机制并未得到良好落实。本研究旨在明确影响2型糖尿病患者从医院转回基层全科医师的转诊流程落地的内科专科医师与患者的认知因素。本研究采用质性研究方法，通过深度访谈、现场观察及焦点小组讨论开展数据采集。研究团队对雅加达南区某医院的8名内科专科医师及2名基层全科医师进行了深度访谈；针对2型糖尿病患者开展了4组焦点小组讨论，并通过现场观察记录该医院的工作环境现状。