Development of a Cardiovascular Patient Referral System under the Greater Mekong Subregion Economic Cooperation Project

Abstract

This research aimed to 1) examine the problems encountered during referral services for patients with cardiovascular diseases, 2) investigate the referral service system for cardiovascular patients, and 3) explore guidelines for developing the referral system under the economic cooperation framework in the Greater Mekong Subregion. This qualitative study collected data from key stakeholders directly involved in patient referral services through in-depth interviews with 19 participants and focus group discussions with 8 participants. Data were collected using interview guides and analyzed through content analysis. The findings indicated that: 1) major challenges in referral services included issues with pre-referral patient information systems, emergency fast-track systems, national security concerns, limited access to specialist consultation, readiness of personnel for cross-border transfers, and coordination constraints related to regulations and legal frameworks; 2) the referral system demonstrated preparedness in coordination, pre-transfer patient preparation, staffing, medical equipment and supplies, transportation, communication, patient care during transfer, and cleanliness of ambulances and equipment; and 3) development guidelines included improving and standardizing personnel performance, enhancing communication systems and technology, strengthening international health system infrastructure, developing shared policies and regulations, and establishing joint funding or health insurance systems. The findings can be used to guide the development of referral systems that align with local contexts and support regional public health collaboration, contributing to sustainable benefits for health systems at both national and subregional levels.