The experience and challenges of healthcare-reform-driven medical consortia and Regional Health Information Technologies in China: A longitudinal study

Liang, Jun; Zheng, Xu; Chen, Zhenying; Dai, Siqi; Xu, Jianliang; Ye, Hui; Zhang, Zhongan; Ge, Fan; Lei, Jianbo

doi:10.1016/j.ijmedinf.2019.103954

Cited by 44 publications

(40 citation statements)

References 22 publications

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“…In 2018, the total number of instances of people using medical and health institutions in China has reached 8.31 billion, an increase of 130 million over the previous year [1], which has put great pressure on medical institutions. In order to improve the level of medical treatment and promote the sustainable development of public health, the State Council further deepened the reform of the medical and health system implemented since 2009 and improved the hierarchical medical system and online appointment diagnosis system [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

2019

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In the study of the sustainable development of public health in China, academic circles have little to do with the unique hierarchical medical system and online appointment diagnosis system in China's medical system. Therefore, based on the medical situation in Shanghai, China, in addition to the traditional dimension of medical expenses, this paper fully considers the impact of the current hierarchical medical policy, constructs a selection model for medical treatment behavior under the hierarchical medical system and online appointment diagnosis system, and carries out simulation analysis through the cellular automata grid dynamic model. This paper finds that the time-cost-oriented medical treatment behavior of Chinese patients will have different distribution under the current hierarchical medical system and online appointment diagnosis system. (1) When the medical treatment system neither allows online appointment nor referral, a large number of patients congregated in high-grade hospitals, with the most unreasonable distribution. (2) With the implementation of the system of allowing referral and online appointment, patients are gradually diverted to lower-grade hospitals or off-peak hours, and the distribution is relatively improved.(3) If the medical treatment system allows both referral and online appointment, the distribution of patients is the most reasonable. Therefore, China's current hierarchical medical system and online appointment diagnosis system will, to a considerable extent, become a policy tool that affects patients' choice of hospitals and an effective means to achieve the rational allocation of existing medical resources, which will play an important role in the sustainable development of public health in China.

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Section: Introductionmentioning

confidence: 99%

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

2019

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“…2 School of Health Care Management (NHC Key Laboratory of Health Economics and Policy Research), Shandong University, Jinan, China. 3 The First Affiliated Hospital of Shandong First Medical University, Jinan, China. 4 University of North Florida, Jacksonville, USA.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…In the Chinese healthcare system, one of the key threats is the unbalanced distribution of quality and accessibility of medical services [1,2] and inappropriate and less cost-effective hospital services leading to an escalation in health expenditure [3][4][5]. Of more concern, this increase has not resulted in improved service provision to patients, and improved outcomes, but an increase in revenue for medical providers and pharmaceutical companies [3][4][5]. In China, 85% of the health services are provided by public hospitals including inpatient services and outpatient consultations.…”

Section: Introductionmentioning

confidence: 99%

Developing senior hospital managers: does ‘one size fit all’? – evidence from the evolving Chinese health system

Liang

Howard

Wang

et al. 2020

BMC Health Serv Res

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Background: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency. Methods: A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan,

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“…The most common collaboration between participants is technical assistance, which characterized as providing technical cooperation or support to each other. This collaboration model bene ts promoting communication and collaboration between different levels of health institutions [6,7]. Meanwhile, it also puts forward higher requirements on the integration ability of health resources and the service quality [8,9].…”

Section: Introductionmentioning

confidence: 99%

Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS): A Development and Validation Study

Deng

Liu²

2020

Preprint

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Background: Limited diffusion and utilization of health technology have greatly halted the improvement of resource integration and healthcare outcomes. However, the dynamic mechanism of health technology diffusion in the context of the integrated care system (ICS) remained largely unknown. The purpose of this study is to develop and validate the scale on Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS) for providing instruments to investigate the health technology diffusion in the ICS. Methods: The scale with 39 items was initially designed on the basis of the proposed model developed from previous research. And it was validated in a cross-sectional questionnaire survey including 246 participants. Exploratory factor analysis was used to assess domains in the questionnaire, and analyzed correlation, factorials, internal consistency and validity of the questionnaire. In addition, structural equation modeling was performed to determine the total effects of each domain on the health technology diffusion in the ICS.Results: Reliability analysis revealed excellent internal consistency, as the value of Cronbach’s alpha greater than 0.80 for all of the four DHTDICS domains in this study. An acceptable validity was confirmed through tests of construct validity, convergent validity and discriminant validity. With respect to the potential domains and dimensions that DHTDICS contributes, the results highlight the existence of 4 domains: personal beliefs, technical drivers, organizational readiness, and external environment. Among them, the impact on health technology diffusion is, in descending order, organizational readiness, personal beliefs, external environment, and technical drivers.Conclusions: The findings of this study support the validity of the DHTDICS, and will be a helpful reference for developing future intervention strategies to promote health technology diffusion in the ICS.

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The experience and challenges of healthcare-reform-driven medical consortia and Regional Health Information Technologies in China: A longitudinal study

Cited by 44 publications

References 22 publications

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

Developing senior hospital managers: does ‘one size fit all’? – evidence from the evolving Chinese health system

Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS): A Development and Validation Study

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