Study on key issues and countermeasures on building the " Eight-integration system" for close-type countywide medical alliances: counties in Fujian province as an example / 中华医院管理杂志

ABSTRACT

Objective:To analyze key issues in the implementation process of the " Eight-integrations system" for close-type countywide medical alliances in Fujian province, and provide references for improving such a mechanism.Methods:Sixteen counties in the province were selected from October to December 2019 and materials were collected by means of interview, questionnaires and field survey. On such basis, the Meter-horn model was used to systematically analyze and evaluate the implementation status, and completion rate was used to describe the implementation of the " Eight-integration system" .Results:The average completion rate of the regions surveyed was 60.15%, of which the mountainous counties being 65.90%, and coastal counties being 47.50%. Of the eight regulations to be integrated, the aspects of better completion include institutions′ names(16 institutions, 100.00%), quality of care(13 institutions, 81.25%), promotions(12 institutions, 75.00%)、staff deployment(11 institutions, 68.75%) and financial management(10 institutions, 62.50%). Those of poor completion rates were drug supply(7 institutions, 43.75%), labor performance(6 institutions, 37.50%)and informationization development(3 institutions, 18.75%). Some of the counties staged localized measures to promote the " Eight-integration system" . Such factors as vague policy objectives, inadequate policy resources, lack of means, biased value orientations of the implementation entities, and complex socio-economic environments influence negatively effective implementation of the system.Conclusions:This system has not yet achieved the expected effects in the implementation process. We should improve the system implementation and its sustained operation by such means as clarifying policy objectives, broadening policy resources, enriching implementation means, enhancing experience exchange and optimizing policy environments.