Patients’ and Care Professionals’ Evaluation of the Effect of a Hospital Group on Integrated Care in Chinese Urban Health Systems: A Propensity Score Matching and Difference-in-Differences Regression Approach
- سال انتشار: 1402
- محل انتشار: مجله بین المللی سیاست و مدیریت بهداشت، دوره: 12، شماره: 0
- کد COI اختصاصی: JR_HPM-12-0_086
- زبان مقاله: انگلیسی
- تعداد مشاهده: 95
نویسندگان
School of Public Health, Sun Yat-Sen University, Guangzhou, China
School of Public Health, Sun Yat-Sen University, Guangzhou, China
School of Public Health, Sun Yat-Sen University, Guangzhou, China
Centre for the Business and Economics of Health, University of Queensland, Brisbane, QLD, Australia
School of Public Health, Sun Yat-Sen University, Guangzhou, China
Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
چکیده
Background A hospital group is an organizational integration strategy that has recently been widely implemented in Chinese urban health systems to promote integrated care. This study aims to evaluate the effect of hospital group on integrated care from the perspectives of both patients and care professionals. Methods Two cross-sectional surveys were conducted in Shenzhen city of China, in June ۲۰۱۸ and July ۲۰۲۱. All ۳۰ community health stations (CHSs) in the hospital group were included in the intervention group, with ۳۰ CHSs in the same district selected as the control group by simple random sampling. All care professionals within both the intervention and the control groups were invited to participate in the surveys. Twelve CHSs were selected from ۳۰ CHSs in the intervention and the control groups by simple random sampling, and ۲۰ patients with type ۲ diabetes mellitus (T۲DM) were selected from each of these selected CHSs to participate in the survey by systematic sampling. The Chinese version Rainbow Model of Integrated Care Measurement Tool (C-RMIC-MT) was used to assess integrated care. Propensity score matching and difference-in-differences regression (PSM-DID) were used to evaluate the effect of the hospital group on integrated care. Results After matching, ۵۲۸ patients and ۱۸۹۶ care professionals were included in the DID analysis. Results from care professionals indicated that the hospital group significantly increased technical competence of the health system by ۰.۷۷۱ points, and cultural competence by ۱.۴۲۳ points. Results from patients indicated that the hospital group significantly decreased organizational integration of the health system by ۰.۶۴۹ points. Conclusion The results suggests that the effect of the hospital group on integrated care over and above routine strategies for integrated care is limited. Therefore, it is necessary to pay attention to implementing professional, clinical and other integration strategies beyond establishing hospital groups, in urban Chinese health systems.کلیدواژه ها
Integrated Care, Hospital group, PSM-DID Method, C-RMIC-MTاطلاعات بیشتر در مورد COI
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