Do medical alliances truly work? Perspectives on health service utilisation among outpatients with chronic diseases in Shanghai, China

Author:

Sun Wanju,Zhu Haiyan,Zhang Linyi,Wang Zhaoxin,Luo Li,Qi Weigang,Qi Hualin,Hua Yingxue,Gao Xiang,Yuan Ling,Shi Jianwei

Abstract

Background To achieve proper health utilisation among various health institutions and improve primary care capacity, China implemented medical alliance (MA) reform as part of healthcare reforms in 2009. With chronic disease management as the focus and priority of primary health institutions, this study aimed to analyse the specific distribution and trends of outpatient visits to various levels of health institutions (community health centres (CHCs) vs hospitals) in MAs. Methods All outpatient data were extracted from the Chuansha MA in Pudong New Area, Shanghai, between 2016 and 2020, and submitted to descriptive analysis, Chi-Square tests and correlation analysis. Results This article found that outpatients aged >60 years visited CHCs more than hospitals for some chronic diseases. The adjusted average costs of outpatients presented upward trends both in hospitals and in CHCs. Conclusions The Chuansha MA worked in guiding older outpatients to visit CHCs, but did not control the increasing medical costs. The Shanghai government should further improve medical capability of CHCs to attract all community-dwelling residents at all ages to implement hierarchical diagnosis and treatment systems, as well as make more efforts to control increasing medical costs.

Funder

Shanghai Jiao Tong University 2021 Annual Hospital Management Construction Project of China Hospital Development Institute

National Key R&D Program of China

National Natural Science Foundation of China

Excellent Academic Leader of Public Health in Shanghai

Health Commission of Pudong New Area Health Scientific Research Project

Philosophy and Social Science Research Major Projects of the Ministry of Education

Shanghai Education Science Research Project

Publisher

CSIRO Publishing

Subject

Public Health, Environmental and Occupational Health,Health Policy

Reference37 articles.

1. Health systems integration: state of the evidence.;International Journal of Integrated Care,2009

2. Launch of the health-care reform plan in China.;The Lancet,2009

3. General practitioners’ perspectives of the integrated health care system: a cross-sectional study in Wuhan, China.;Family Practice,2021

4. The impact of patient-centered medical homes on safety net clinics.;American Journal of Managed Care,2016

5. A comparative study of patients’ satisfaction with different levels of hospitals in Beijing: why do patients prefer high-level hospitals?;BMC Health Services Research,2020

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3