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
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 pro...
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| Format: | Article |
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Kerman University of Medical Sciences
2023-12-01
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| Series: | International Journal of Health Policy and Management |
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| Online Access: | https://www.ijhpm.com/article_4531_f40742951dc7eb9d61af744cfaa6b928.pdf |
| _version_ | 1797206317338722304 |
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| author | Xin Wang Caiyun Zheng Yao Wang Stephen Birch Yixiang Huang Pim Valentijn |
| author_facet | Xin Wang Caiyun Zheng Yao Wang Stephen Birch Yixiang Huang Pim Valentijn |
| author_sort | Xin Wang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T09:05:06Z |
| format | Article |
| id | doaj.art-5e481fc13b2e4c0b91cc1a677c8beaf0 |
| institution | Directory Open Access Journal |
| issn | 2322-5939 |
| language | English |
| last_indexed | 2024-04-24T09:05:06Z |
| publishDate | 2023-12-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-5e481fc13b2e4c0b91cc1a677c8beaf02024-04-15T19:04:25ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392023-12-0112Issue 11910.34172/ijhpm.2023.78974531Patients’ 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 ApproachXin Wang0Caiyun Zheng1Yao Wang2Stephen Birch3Yixiang Huang4Pim Valentijn5School of Public Health, Sun Yat-Sen University, Guangzhou, ChinaSchool of Public Health, Sun Yat-Sen University, Guangzhou, ChinaSchool of Public Health, Sun Yat-Sen University, Guangzhou, ChinaCentre for the Business and Economics of Health, University of Queensland, Brisbane, QLD, AustraliaSchool of Public Health, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The NetherlandsBackground 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.https://www.ijhpm.com/article_4531_f40742951dc7eb9d61af744cfaa6b928.pdfintegrated carehospital grouppsm-did methodc-rmic-mt |
| spellingShingle | Xin Wang Caiyun Zheng Yao Wang Stephen Birch Yixiang Huang Pim Valentijn 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 International Journal of Health Policy and Management integrated care hospital group psm-did method c-rmic-mt |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | integrated care hospital group psm-did method c-rmic-mt |
| url | https://www.ijhpm.com/article_4531_f40742951dc7eb9d61af744cfaa6b928.pdf |
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