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People-centred integrated care in urban China

机译:中国城市以人为本的综合护理

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摘要

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.
机译:在大多数国家,随着人口老龄化,对慢性病患者的综合护理的需求在增加。这种需求要求医疗保健系统从根本上转向更加集成的服务提供模式。为了在中国实现这一转变,世界卫生组织,世界银行和中国政府提出了以人为本的综合医疗模式的分级医疗服务体系。该方法于2015年至2017年在深圳市罗湖区开创,作为实践的模板。 2017年9月,中国卫生部将这种方法引入了以人为本的综合医疗服务体系。我们描述了罗湖模型与核心行动领域和拟议实施策略相关的特征,并总结了该计划前两年的评估数据。我们讨论了在实施过程中面临的挑战以及从中汲取的其他卫生保健系统的经验教训。我们考虑如何改善机构之间的协作,如何改变人们将社区卫生服务用作第一联系点的行为,以及如何有效地管理资源以避免预算赤字。最后,我们概述了罗湖模型的后续步骤及其在其他城市卫生保健系统中加强卫生保健的潜在应用。

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