Does A Medical Consortium Influence Health Outcomes of Hospitalized Cancer Patients? An Integrated Care Model in Shanxi, China

Abstract

Objective:To assess the effect of the medical consortium policy on the outcomes of cancer patients admitted to secondary hospitals in Shanxi, China.Method:Electronic medical records of lung cancer (n = 8,193), stomach cancer (n = 5,693) and esophagus cancer (n = 2,802) patients hospitalized in secondary hospitals were used. Propensity score matching was used to match each patient enrolled in medical consortium hospitals with a counterpart admitted in non-medical consortium hospitals. Cox proportional hazard models were used to estimate the hazard ratio of patients enrolled different categories of hospitals.Results:The hazards of lung, stomach and esophageal cancer patients admitted in medical consortium hospitals were consistently and significantly lower than those admitted in non-medical consortium hospitals after adjusting for a number of potential confounders. Lower hazard ratios were associated with lung (hazard ratio (HR) = 0.533, p < 0.001), stomach (HR = 0.494, p < 0.001), and esophagus (HR = 0.505, p < 0.001) cancer patients in medical consortium hospitals.Conclusion:The medical consortium provides an effective strategy to improve the outcomes of cancer patients in Shanxi, China. The partnerships between top-tier hospitals and grassroots medical services bridge the gap in resources and plays a critical role in the quality of care in China.

Patient Choice and Willingness Toward Gatekeepers as First-Contact Medical Institutions in Chinese Tiered Healthcare Delivery System: A Cross-Sectional Study

“…For construction of TDS specifically, efforts should be taken for a better vertical integration of urban and rural health resources ( 39 ). Potential measures could include developing distance medical services, forming exports teams to contribute to improve medical skills of staff, consultation of patients, health education, and providing smooth two-way referral in rural areas ( 44 , 45 ). Besides, the number of general practitioners is still insufficient in this country given the largest population in the world and way lags behind the growth in the numbers of specialists ( 46 ).…”

<p>Comparing the Performance of Charlson and Elixhauser Comorbidity Indices to Predict In-Hospital Mortality Among a Chinese Population</p>

“…[13][14][15][21][22][23] The large volume of patients in China, together with fast-developing health information systems, furnishes a promising opportunity to enlighten healthcare practice and policy-making based on real-world evidence. [24][25][26][27] Although a growing number of researchers are applying the American-population-based CCI and ECI to a Chinese population, there is no evidence of cross-population generalizability of these comorbidity indices using Chinese administrative data. [28][29][30][31] Therefore, this study aims to evaluate the predictive accuracy of five commonly used indices in in-hospital mortalities of four disease cohorts based on a large administrative database in Shanxi, China.…”

Understanding the Implementation of Hierarchical Medical System Policy: An Interrupted Time Series Analysis of a Pilot Scheme in China

“…Gatekeeping promoted PCP-coordinated care services and thus integration of care delivery across tiers as family doctors maintained close working relationships with [22,40] professionals at higher-tier hospitals [4]. [41,42] Family doctors also facilitated the integration of services at the primary care level led a multidisciplinary team to provide comprehensive services. The team included a family doctor, a nurse, a public health specialist, and so forth.…”