Patient Experiences with Back-Referral Under a Tertiary Hospital Restructuring Pilot Project in South Korea

Background: To improve the healthcare delivery system, the Korean government launched a tertiary hospital restructuring pilot project in September 2024; this project aims to prioritize the treatment of severe, urgent, and rare diseases through a strengthened back-referral system.Understanding patient experiences during interhospital transfers is essential for identifying factors related to the quality, safety, and patient-centeredness of care transitions.The primary aim of this exploratory study was to evaluate patient experiences, determine the reasons for back-referral from tertiary to secondary or community-based hospitals, and identify the determinants of hospital choice during the early stages of the restructuring pilot project.Methods: A cross-sectional survey was performed via computer-assisted telephone interviews with 102 patients discharged from 33 tertiary hospitals in December 2025.The study assessed the determinants of hospital selection, primary purposes for referral, and patient experiences.Results: While participants reported clear explanations regarding referral necessity (80.4%) and process (74.5%), their awareness of the transfer of clinical information to receiving physicians was lower (63.0%).Primary factors for hospital selection were proximity and convenience (42.4%), followed by referral arranged by the referring hospital (31.5%).The primary reason for back-referral was the necessity for rehabilitative or long-term care (46.1%).Conclusion: Although patients reported uniformly positive communication experiences, the strength of agreement was somewhat lower for the awareness of the receiving hospital towards clinical information than for other items.Strengthening standardized data-sharing protocols may further enhance the continuity of clinical information between providers and support seamless back-referrals.