Study Of Influences Of Continuity Medical Care Under Different Collaborative Models Among Hospitals And Community Health Service Center

Purpose of investigationThe concept of continuity care, presented in about 1960s, receives more and more attention and is seen to be the absolute choice to surpass the fracture of health services. Kinds of collaborative models between hospitals and Community Health Service Institutes were founded all over the country, which lain the foundation for the extension of continuity cares in different degrees. However, whether different collaborative models can change the nature of connection and delivery of health services, and how to carry out continued health service more effectively on the basis of different collaborative models, need to be investigated more deeply.In this essay, on the basis of current situation of continuity medical care under different collaborative models is analyzed. Moreover, both positive and negative influences lain by different collaborative models are deeply analyzed and critical intervention point is found out to provide suggestions for further continuity medical care. Method for investigation1.Reference and analysis On the basis of relevant theories, conceptual framework of continuity medical care provided among hospitals and Community Health Service Institutes, is set up. At the same time, references about different collaborative models and policies are looked up.2.Questionnaire survey The survey was performed among medical staff from Community Health Service Institutes on site. Their understanding and actions about information, patients, service delivery, organizational collaboration and communicating with medical staff from collaborative hospitals under these three collaborative models of direct administration, trusteeship and partnership assistance were gained on the basis of four angles of view. 3.In-depth interview Those persons in the know were interviewed about the deeper reason and the different influences on the continuity services lain by collaborative models among hospitals and Community Health Service Institutes, which laid foundation for the analysis of influences lain by different collaborative models among hospitals and Community Health Service Institutes.4.Statistical analysis The survey data was quantitatively analyzed by spss12.0. In the analysis, hypothesis was tested by descriptive analysis such as frequency percentage and chi square test.5.Qualitative analysis Those influences were analyzed by word enumeration method. After that, the relationship and operation among those influential subjects were constructed by schema analysis method, which provides the theoretical foundation for the breakthrough point of policy in the process of carrying out continuity health services.Results and conclusions1.The fundamental investigation of continuity health services among hospitals and Community Health Service Institutes Conceptual framework, which is fit for providing continuity health services among hospitals and Community Health Service Institutes, was constructed through these four angles of view such as information continuity, agency continuity, subjects continuity and interpersonal continuity.2. Study of the collaborative models among hospitals and Community Health Service Institutes3.Investigation about the current situation of continuity health services among hospitals and Community Health Service Institutes under collaborative models Information continuity, there are some problems in the following aspects. Firstly, formal and stable ways are needed to transport information. Secondly, differences only exist in the aspects of tracing patients'information and the difficulty level of tracing, which indicates that the certainty and convenience of paths for medical staff to trace patients'information among agencies are different. Last but not the least, the information flows from different agencies have not been combined together yet. Agency continuity, the level of referral professionalization is weakened to different degree. Secondly, the perfection of the measures corresponding to the referral services is different to some degree. Thirdly, there is lacuna of concept and paths for cohesion of referral services on the basis of the cooperation of different agencies. Subject continuity is not as positive as imagined. Interpersonal continuity, their common problems lie in the following two aspects. The first is patients place too much influence during the process of patients and medical staff being familiar with each other. The second is that there is little meaning even if different service providers are familiar with each other.4.Investigation about the influence on the continuity health services lain by the collaborative models among hospitals and Community Health Service Institutes4.1The influence placed by the direct administration model includes three main aspects. The one is to strengthen the relationship among different agencies and make the influence more powerful. Another is that the main constraint of the continuity service is the deviation of service ways and concepts. The other is that the influence on continuity health services placed by referral is double sided.4.2The influence placed by the trusteeship model lies in the following aspects. Coordination of interests becomes the isolated layer because it determines the hospitals in fact. The stage created for continuity health services is limited, since this stage is close related with the relationship in which links among the management team take the main part. Government, playing the role of outside constraint force, places macroscopic influence on the realization of continuity health services. Under the conditions of referral services, there is not enough influence on the critical connection of different agencies.4.3The influence placed by the partnership assistance model includes the following aspects.The effectiveness for the regulatory system to coordinate the conflicts about interests of different agencies lays the foundation of stable division of responsibilities. It is difficult to construct the bidirectional communication web for those different agencies. The continuity services are influenced negatively as there is not essential transformation of the referral services.5. Discussions and suggestions5.1 Discussions Firstly, it is beneficial for hospitals and Community Health Service Institutes to set up different collaborative models, as some positive conditions will be created during this process. Secondly, direct administration model is better than the other two when they are compared in the aspect of creating beneficial conditions for continuity services on the basis of those four fundamental dimensions. The problems and limitations of collaborative models are further discussed.5.2 Suggestions about policies Firstly, the construction of the environment for continuity health services. And more deeper and pointed suggestions are offered about the continuity health services under those three kind of collaborative models.