城市公立医院改革背景下整合型医疗服务理论框架研究

Objective: To construct the theoretical framework of integrated care in the context of deepening urban public hospital reform. Methods: Middle-ranged theory research(induction) was used. Results: The dual-core integrated care framework described the integrated care on macro-level, meso-level, dynamic factors and micro-level respectively. In macro-level, deepening public hospital reform, driving the improvement of basic medical service ability and promoting the adjustment of structure and element of medical service system were the basis of system integration. In meso-level, it was needed to build partnerships between health care facilities and professionals. In dynamic factors level, key functions integration was needed in medical institutions, including profits, information and human resources, etc. Common service culture was achieved through regulation and integration. In the micro-level, patient empowerment was crucial. In addition, the clinic decision-making supporting and incentive-restraint system was essential. Although the health care system can be started from any level, for further development, functional integration and normative integration are the key enabler factors. Conclusion: Under the circumstances of inverted health resources allocation in China, the dual-core integrated care framework could help forecast, design and manage integrated care from the perspective of urban public hospitals.