People-centred integrated care in urban China

Abstract

In most countries, the demand for integrated care for people with chronic diseases is increasing as the population ages. This demand requires a fundamental shift of health-care systems towards more integrated service delivery models. To achieve this shift in China, the World Health Organization, the World Bank and the Chinese government proposed a tiered health-care delivery system in accordance with a people-centred integrated care model. The approach was pioneered in Luohu district of Shenzhen city from 2015 to 2017 as a template for practice. In September 2017, China’s health ministry introduced this approach to people-centred integrated care to the entire country. We describe the features of the Luohu model in relation to the core action areas and implementation strategies proposed and we summarize data from an evaluation of the first two years of the programme. We discuss the challenges faced during implementation and the lessons learnt from it for other health-care systems. We consider how to improve collaboration between institutions, how to change the population’s behaviour about using community health services as the first point of contact and how to manage resources effectively to avoid budget deficits. Finally, we outline next steps of the Luohu model and its potential application to strengthen health care in other urban health-care systems.

How Do Type 2 Diabetes Patients Value Urban Integrated Primary Care in China? Results of a Discrete Choice Experiment

“…">Study SettingNanshan is one of the ten districts in Shenzhen city, with an area of 182 km 2 and 1.4246 million people. Shenzhen has been a leader in developing integrated healthcare systems in China [23,24]. There is a city-level hospital, five district-level hospitals, and 80 community health stations (CHSs) in Nanshan.…”

Building a People-Centred Integrated Care Model in Urban China: A Qualitative Study of the Health Reform in Luohu

“…As discussed in previous literature [24][25][26][27][28], the Luohu model generated valuable lessons for integrated care initiatives in China, particularly the establishment of ISDN. ISDN were faced with several shared challenges to achieving integrated care [40,41].…”

“…As an urban district of Shenzhen, Luohu had one million population, and it's per capita Gross Domestic Product was $31,517 in 2017 [23]. Luohu Hospital Group was established in August 2015 after integrating five district-level public hospitals and 23 public community health centres [24][25][26]. By July 2017, Luohu Hospital Group had more than 575 thousand registered clients [25].…”

“…Luohu Hospital Group was established in August 2015 after integrating five district-level public hospitals and 23 public community health centres [24][25][26]. By July 2017, Luohu Hospital Group had more than 575 thousand registered clients [25]. The Luohu model was viewed as the template for building a people-centred integrated care model in urban China [25].…”

“…By July 2017, Luohu Hospital Group had more than 575 thousand registered clients [25]. The Luohu model was viewed as the template for building a people-centred integrated care model in urban China [25]. The Luohu model involved fundamental changes in the governance structure, payment method, care delivery model, and organisational culture.…”