International Journal of Health Policy and Management

International Journal of Health Policy and Management

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

Document Type : Original Article

Authors
Xin Wang 1
Caiyun Zheng 1
Yao Wang 1
Stephen Birch 2
Yixiang Huang 1
Pim Valentijn 3, 4
1 School of Public Health, Sun Yat-Sen University, Guangzhou, China
2 Centre for the Business and Economics of Health, University of Queensland, Brisbane, QLD, Australia
3 Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
4 Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, The Netherlands
10.34172/ijhpm.2023.7897
Abstract
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 2018 and July 2021. All 30 community health stations (CHSs) in the hospital group were included in the intervention group, with 30 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 30 CHSs in the intervention and the control groups by simple random sampling, and 20 patients with type 2 diabetes mellitus (T2DM) 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, 528 patients and 1896 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 0.771 points, and cultural competence by 1.423 points. Results from patients indicated that the hospital group significantly decreased organizational integration of the health system by 0.649 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.
Keywords
Integrated Care
Hospital Group
PSM-DID Method
C-RMIC-MT 
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International Journal of Health Policy and Management
Volume 12, Issue 1
2023
Pages 1-9

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  • Received Date 19 December 2022
  • Revised Date 10 October 2023
  • Accepted Date 28 October 2023
  • First Published Date 29 October 2023
  • Published Date 01 December 2023