Self-referral motives
That was acknowledged upward referral would provide patients more
opportunities to seek for high-quality health care resource, including
system resources and capacity. Higher healthcare facility was the
default choice when kidney disease out of control.
“Whether medical facilities or specialists were advanced than
primary hospitals. If it’s inevitable to adopt replacement, diagnosis
and operation should be done accurately and successfully.” (P1)
Especially, newly diagnosed ESRD patients, who were at shock and denial
stage, have attempted self-referral to reverse progression of kidney
disease. Initial self-referral patients expressed that the strongest
consideration was to change the status quo.
“We didn’t really believe existing diagnosis and felt a bit
chance to bargaining…. We were so indecisive and resist that we
didn’t know what to do. We pinned hope on referral hospitals which were
famous for kidney diseases to initiate dialysis as late as possible.”(P5)
Several participants described negative self-referral motives, occurring
after definite diagnosis. Self-referral was placebo than health seeking
behavior.
“Going to this hospital once each month for monitoring creatinine
concentration is mymandatory
work while waiting for the dialysis. I know I am at stake…I
anticipate the deadline for dialysis.” (P13)
Negative self-referral was mainly decided by families while patients
didn’t show strong
rebuttal.
“In fact, I was reluctant to refer to this hospital because it
was the same anywhere. However, my son tried to persuade me more than
once… I just didn’t want to disappoint him.” (P9)