Dilemmas and strategies for collaborative governance of medical preventive integration based on SFIC model / 中华医院管理杂志

Promoting medical preventive integration and improving its collaborative mechanism is an inevitable requirement for achieving the transformation of China′s medical and health care system from " disease centered" to " people′s health centered" and providing comprehensive and comprehensive health services for the people.This study established a research framework based on the SFIC model on the basis of clarifying the collaborative subjects of medical preventive integration, sorted out the dilemma of medical preventive integration collaborative governance in China from five aspects, including external environment, starting conditions, facilitative leadership, institutional design and collaborative process.In order to break the dilemma of medical preventive integration and promote collaborative governance among multiple subjects, the authors proposed such optimization strategies, including further improving relevant laws, regulations, and policy systems, filling resource gaps, attracting multiple entities to participate, providing reference for promoting China′s medical preventive integration work.

Analysis on the operation mode and effect of medical preventive integration in county scale medical alliances in Hangzhou / 中华医院管理杂志

Objective:To explore an effective mode of medical preventive integration, so as to further the construction of county scale health-centered medical alliances.Methods:This study took five medical alliances from a county in Hangzhou as an example, and carried out the semi-structured interview method and typical case analysis to summarize the medical preventive integration operation mode in January 2020; the self-developed questionnaire was used to understand the operation effectiveness evaluation on county medical alliances by medical staffs and residents from fowr aspects: medical preventive team, medical preventive resources, medical preventive services and medical preventive information fusion.Results:Each county scale medical alliance promoted the integration of medical preventive by innovating the organizational structure, strengthening organizational guarantees, and integrating teams, resources, services, and information on medical preventive. The questionnaire survey showed that medical staff had highest satisfaction with the medical preventive service integration (3.75 points), and lowest satisfaction with the medical preventive information integration (3.69 points); residents had highest satisfaction with health information functions in medical preventive information fusion (4.20 points), and lowest satisfaction with preventive health care services in medical preventive services fusion (4.15 points).Conclusions:The evaluation measures related to medical preventive integration services need to be improved, and the quality of services needs to be promoted, all the information systems need to be interconnected, and big data on the information platform needs to be mined and utilized.

Analysis on the current situation of medical preventive integration at primary medical institutions in a city / 中华医院管理杂志

Objective:To explore the current status of medical preventive integration at primary medical institutions, analyze the problems of medical prevention integration, and put forward optimization suggestions.Methods:From June to July 2020, 169 primary medical institutions in a city were selected as the survey objects to conduct a questionnaire survey on the basic information of institutions and the evaluation indicators of medical preventive integration. The evaluation index system of medical preventive integration was divided into a factual survey and a sensory survey. In addition, 32 relevant personnel were interviewed on the current situation of medical preventive integration at primary medical institutions. The reliability and validity of the data were tested and analyzed, while descriptive analysis and classification extraction analysis were carried out.Results:The reliability and validity analysis proved the data reliability. The factual survey extracted three common factors, namely organization management, performance appraisal distribution and information management. The sensory survey extracted two common factors, namely working mode and personnel training. In terms of organization, management and working methods, the degree of medical preventive integration was low. Among them, 53.8% of the institutions had formulated the medical preventive integration norms, and only 41.4% of them had shared residents′ health information in time.Conclusions:The degree of medical preventive integration of primary medical institutions in the city still need to be improved. In the future, we should strengthen the top-level design, establish the norms and cooperation mechanism of medical preventive integration, improve the awareness of medical preventive integration of medical personnel, improve the information level, and to build a new service model integrating disease prevention, medical treatment and health management.