Do medical alliances truly work? Perspectives on health service utilisation among outpatients with chronic diseases in Shanghai, China
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Published:2023-01-31
Issue:4
Volume:29
Page:332-340
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ISSN:1448-7527
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Container-title:Australian Journal of Primary Health
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language:en
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Short-container-title:Aust. J. Prim. Health
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
Cited by
1 articles.
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