Evaluation and Analysis for Chinese Medical Alliance’s Governance Structure Modes Based on Preker-Harding Model

Abstract

Introduction Medical alliance refers to a group of medical institutions or joint organizations formed by the integration of horizontal or vertical medical resources in different regions and types of medical institutions within a certain region, the medical institutions are mutually beneficial and responsible communities [1]. According to the closeness of the contact, the medical alliance can be divided into three types: compact, semicompact and loose [1]. A compact medical alliance is an operational management mode that forms a community of responsibilities and interests among various health service organizations within a medical alliance, and all people and property implement unified operational management; The semi-compact medical alliance refers to an operational management mode formed by the contract or agreement from the core hospital to the primary health center on the basis that the nature of the assets of various medical service institutions does not change in the medical alliance; Loose medical alliance means that all kinds of health service organizations in the medical alliance only cooperate in medical technology, personnel training, equipment and other aspects. However, various medical and health institutions within the medical alliance are not affiliated. The medical alliance is an important carrier of hierarchical medical system. Its establishment is an effective exploration and practice mode to optimize the allocation of medical resources, improve the service level of primary medical institutions, control the cost of medical and pharmaceutical services, improve the patient experience, and comprehensively improve the health management level and chronic disease management level [2, 3]. The structure, process, and outcome of medical services involve multiple subjects such as patients, doctors, hospitals, government, and society. This places high demands on the allocation of medical resources. This is a comprehensive governance process. However, as the medical service environment becomes more and more complex, the traditional medical service organization mode can no longer meet the requirements of modern medical services for efficiency and social responsibility [4]. Due to the increase in medical risks and the pressure on the medical service market, integrated delivery networks INTEGRATED CARE CASE

Exploring Formation Mechanism of Medical Collaborative Practices in Multi-level Market from an Infra-marginal Perspective

“…a process that occurs when a group of autonomous stakeholders with various medical resources to communicate and coordinate each other to share decision making, goal setting, and implementation of a plan of care [3,10,12]. The members of medical collaborative community have both cooperation and division of labor.…”

“…One is to develop a large-scale comprehensive hospital, emphasizing the interprofessional collaborative relationships within intra-organization, such as the First Affiliated Hospital of Zhengzhou University, which has 7000 beds. At the same time, the state and local governments in China have issued a series of policies to develop inter-professional medical collaboration among different medical institutions, such as the new rural cooperative medical scheme (NCMS) (for protecting rural households from catastrophic medical expenditure) [1,2], and the various medical consortia (for improving the system of tiered medical service to balance inadequate medical resources) [3].…”

Evaluating the Inequality of Medical Resource Allocation Based on Spatial and Non-Spatial Accessibility: A Case Study of Wenzhou, China

“…Currently, the supply of medical resources in China displays an "inverted triangle" pattern; high-quality medical resources are primarily concentrated in metropolitan areas and large hospitals, whereas grassroots medical institutions have few high-quality talents and poor service capacity. Most medical resources and patients are concentrated in tertiary hospitals, which account for 8% of all medical institutions and are primarily located in urban areas [6]. In addition, the income disparity between regions widened, resulting in the unbalanced development of regional medical and health infrastructure and the unbalanced distribution and allocation of medical resources.…”

Mechanism of Impact of Big Data Resources on Medical Collaborative Networks From the Perspective of Transaction Efficiency of Medical Services: Survey Study

“…Most health care reforms have tried to encourage a variety of medical collaborative practices as a means to improve the quality and efficiency of health care delivery. For example, the New Rural Cooperative Medical Scheme was launched to protect rural households from catastrophic medical expenditure [1] and various medical consortia were mainly used to improve the system of tiered medical services to balance inadequate medical resources [2]. These studies often assumed that medical collaborative networks (MCNs) are exogenous and had already been formed.…”