School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, PR China.
Health and Wellbeing Research Unit (HoWRU), Macquarie Business School, Macquarie University, Sydney, Australia.
Glob Health Action. 2024 Dec 31;17(1):2430811. doi: 10.1080/16549716.2024.2430811. Epub 2024 Nov 19.
China is transforming its hospital-centric service delivery system into a people-centered integrated care model, with service delivery organized around the health needs and expectations of people.
To guide reforms and align with public expectations, this study profiles successful integration in primary health care from the public perspective.
Guided by the rainbow model of integrated care, semi-structured interviews were conducted in six provinces in China. A total of 58 interviewees completed the interviews. Tape-based analysis was used to produce narrative summaries. Researchers listened to the recordings and summarized by 30-s segments. Thematic analysis was performed on summaries to identify thematic families.
Five themes and 16 sub-themes were generated. Respondents' expectations were primarily on three themes: clinical integration (such as interaction between professional and client, continuity, and empowering and engaging individuals), functional integration (such as resources management, quality improvement, and reforming payment systems), and system integration (such as institutional distribution and supervision). Yet a few interviewees mentioned professional integration (multi-disciplinary collaboration) and organizational integration (inter-organizational strategy).
Qualitative data were used to reveal public perceptions of successful primary health care integration. Service processes, institutional distribution, regulation, resource management, and quality improvement are more visible to the public and will be priorities for future efforts. Whereas inter-organizational strategies and multi-disciplinary collaboration have been shown to facilitate service improvements. Future efforts could consider how policy efforts can be grounded in visible service delivery through management practices.
中国正在将以医院为中心的服务提供系统转变为以人民为中心的整合型医疗服务模式，服务提供围绕人民的健康需求和期望展开。
为了指导改革并符合公众期望，本研究从公众角度描述了初级卫生保健中成功的整合情况。
本研究以整合照护彩虹模型为指导，在中国六个省份进行了半结构式访谈。共有 58 名受访者完成了访谈。采用基于录音带的分析方法生成叙事性总结。研究人员听取录音并按 30 秒的片段进行总结。对总结进行主题分析，以确定主题系列。
生成了五个主题和 16 个子主题。受访者的期望主要集中在三个主题上：临床整合（如专业人员和客户之间的互动、连续性、赋权和吸引个人）、功能整合（如资源管理、质量改进和改革支付系统）和系统整合（如机构分布和监督）。但也有少数受访者提到了专业整合（多学科协作）和组织整合（组织间策略）。
本研究使用定性数据揭示了公众对初级卫生保健成功整合的看法。服务流程、机构分布、监管、资源管理和质量改进对公众更为可见，将成为未来努力的重点。而组织间策略和多学科协作已被证明有助于改善服务。未来的努力可以考虑如何通过管理实践将政策努力建立在可见的服务提供基础上。
