Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China.
Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China.
J Healthc Eng. 2021 Sep 20;2021:8976625. doi: 10.1155/2021/8976625. eCollection 2021.
There is a need to assess the 2009 new healthcare reform in China on hypertension prevention. It helps to control from the perspectives of multisectoral participation, government responsibility assignment, performance assessment, and service delivery.
Interrupted time-series study. . 31 provinces in mainland China. Based on the content analysis of publicly available policy documents from 31 provinces regarding hypertension prevention and control, we analyzed the changes brought by the 2009 new healthcare reform through four quantitative indicators, including multisector participation (MP), main department responsibility coverage (MDRC), primary department assessment indicator coverage (MDAIC), and service type coverage (STC). We compared the changing trends of four indicators before and after 2009.
Nationally, MP, MDRC, and STC grew rapidly and increased to 88.9%, 96.4%, and 77.8%, respectively, in 2017, higher than MDAIC (36.9%). This growth was accelerated by the new healthcare reform, with the highest acceleration in MP (3 = 6.345, < 0.001), followed by MDRC (3 = 3.829, < 0.01), STC (3 = 3.799, < 0.001), and MDAIC (3 = 3.585, < 0.001). The MP and MDRC trend changes were higher in the central and western regions than in the east after the reform.
Our research showed that the new healthcare reform had a positive effect in promoting multisectoral participation in preventing and controlling hypertension in China, improving the responsibility mechanism, and expanding the types of services provided. The government should lead the coordination and implementation of multidepartmental responsibilities and mobilize nonhealth departments to continuously participate in the prevention and control of chronic diseases by improving incentive and evaluation mechanisms.
评估 2009 年中国新医改对高血压防治的影响。这有助于从多部门参与、政府责任分配、绩效评估和服务提供等方面进行控制。
中断时间序列研究。中国大陆 31 个省。我们基于对中国大陆 31 个省份高血压预防和控制相关政策文件的内容分析，通过多部门参与（MP）、主要部门责任覆盖（MDRC）、初级部门评估指标覆盖（MDAIC）和服务类型覆盖（STC）等四个定量指标分析了 2009 年新医改带来的变化。我们比较了 2009 年前后四个指标的变化趋势。
全国范围内，MP、MDRC 和 STC 迅速增长，到 2017 年分别达到 88.9%、96.4%和 77.8%，高于 MDAIC（36.9%）。新医改加速了这一增长，其中 MP 的增速最快（3=6.345，<0.001），其次是 MDRC（3=3.829，<0.01）、STC（3=3.799，<0.001）和 MDAIC（3=3.585，<0.001）。改革后，中西部地区的 MP 和 MDRC 趋势变化高于东部地区。
我们的研究表明，新医改在中国促进了多部门参与高血压防治工作，完善了责任机制，扩大了服务提供类型，具有积极作用。政府应通过完善激励和评估机制，引领多部门协调实施责任，动员非卫生部门不断参与慢性病防控工作。
