Wang Xin, Sun Xizhuo, Gong Fangfang, Huang Yixiang, Chen Lijin, Zhang Yong, Birch Stephen
School of Public Health, Health Development Research Center, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, CN.
Shenzhen Luohu Hospital Group, No. 47 Youyi Road, Shenzhen, CN.
Int J Integr Care. 2018 Oct 12;18(4):3. doi: 10.5334/ijic.3955.
Emerging from the epidemiological transition and accelerated aging process, China's fragmentated healthcare systems struggle to meet the demands of the population. On Sept 1 2017, China's National Health and Family Planning Commission encouraged all cities to learn from the Luohu model of integration adopted in Luohu as an approach to meeting these challenges. In this paper, we study the integration process, analyze the core mechanisms, and conduct preliminary evaluations of integrated policy development in the Luohu model.
The Luohu hospital group was established in Aug 2015, consists of five district hospitals, 23 community health stations and an institute of precision medicine. The group adopted a series of professional, organizational, system, functional and normative strategies for integrated care, which was provided for the residents of Luohu, especially for the elderly population and patients with chronic conditions. According to a preliminary evaluation of the past two years, the Luohu model showed improvement in the structure and process towards integrated care. New preventive programs conducted in the hospital group resulted in changes of disease incidence. Residents were more satisfied with the Luohu model. However, spending exceeded the global budget for health insurance because of short-term increases in the demand for health care.
First, engagement of multiple stakeholders is essential for the design and implementation of reform. Second, organizational integration is a prerequisite for integrated care in China. Third, effective care integration requires alignment with payment reforms. Fourth, normative integration could promote collaboration in an integrated healthcare system.
Core strategies and mechanisms of the Luohu model will promote integrated care in urban China and other countries facing the same challenges. However, it is necessary to study the effects of the Luohu model over the long term and continue to strive for integrated care.
随着流行病学转变和老龄化进程加速，中国碎片化的医疗体系难以满足民众需求。2017年9月1日，中国国家卫生和计划生育委员会鼓励所有城市借鉴罗湖采用的整合模式来应对这些挑战。在本文中，我们研究了整合过程，分析了核心机制，并对罗湖模式下的整合政策发展进行了初步评估。
罗湖医院集团于2015年8月成立，由五家区级医院、23个社区卫生服务站和一家精准医学研究院组成。该集团采取了一系列专业、组织、系统、功能和规范的策略来提供整合照护，服务对象为罗湖居民，尤其是老年人群体和慢性病患者。根据对过去两年的初步评估，罗湖模式在整合照护的结构和流程方面有所改善。医院集团开展的新预防项目导致了疾病发病率的变化。居民对罗湖模式更为满意。然而，由于医疗保健需求的短期增加，支出超出了医疗保险的全球预算。
第一，多方利益相关者的参与对于改革的设计和实施至关重要。第二，组织整合是中国整合照护的先决条件。第三，有效的照护整合需要与支付改革相匹配。第四，规范整合可以促进整合医疗体系中的协作。
罗湖模式的核心策略和机制将推动中国城市及其他面临相同挑战的国家的整合照护。然而，有必要长期研究罗湖模式的效果，并继续为整合照护而努力。
