Research Into The Factors Of Vertical Integration Between Hospitals And Community Health Service Centers

With the deepening of the medical system reform, vertical integration between different levels of medical institutions has become an important way to promote the rational flow of medical resources. Integration models between the different levels of medical institutions are varied and their results are also different.The study analyzes the factors affecting the vertical integration between hospital and community health service centers and finds the motivation and resistance of integration, in order to lay a good foundation for putting forward proper strategies and policy recommendations to promote the vertical integration of hospital and community health service centers.Objective: Constructing factors index system of vertical integration between hospital and communities and analyzing the theme framework of factors, in order to perfect the vertical integration system between hospitals and communities and provide a reference for others.Methods: In order to collect preliminary data, the literature review, expert consultation, questionnaire survey, in-depth personal interviews are applied. To establish the factors index system of vertical integration between hospitals and communities, the Delphi expert consultation method and Analytic hierarchy process(AHP) are applied. What’s more, the theme framework analysis is used to analyze the factor themes.Results:(1) Factors index system of vertical integration between hospital and communities is constructed through Delphi expert consultation method and AHP, which includes 4 first-level indicators, 10 secondary indicators, 36 tertiary indicators.(2) The questionnaire survey is investigated on the medical institutions managers and medical staff. Quantitative analysis is used on the major stakeholders by the indicators understanding of the policy, position, the ability of affecting the implementation of integration.(3) Factors theme framework of three patterns of vertical integration is produced by qualitative interview analysis, which includes 8 similarities and 5 differences.Conclusion: Factors affecting the vertical integration between hospitals and community health centers are classified from the perspective of stakeholders. Government policy supportment and investment、Financial supportment from related departments、supervision and evaluation mechanism of government is perfect or not、Medical insurance payments、Reimbursement gap between medical institutions at different levels and Special reimbursement policy designed for referral patients are included from the perspective of related department. Workload of medical staff、influence on the benefits of hospitals’ leaders and employees of integration、Competitive pressures and development demands of hospitals in the medical market are included from the perspective of hospitals. Community service capabilities、influence on the bemefits of communities’ leaders and employees of integration and influence on the improvement of communities’ capabilities are included from the perspective of community health centers. Habits of choosing hospitals and doctors of residents、severity of patients’ disease、residents’ trust in communities’ health centers、residents’ awareness and evaluation in integration are included from the perspective of patients.