Introduction Medical alliance refers to a group of medical institutions or joint organizations formed by the integration of horizontal or vertical medical resources in different regions and types of medical institutions within a certain region, the medical institutions are mutually beneficial and responsible communities [1]. According to the closeness of the contact, the medical alliance can be divided into three types: compact, semicompact and loose [1]. A compact medical alliance is an operational management mode that forms a community of responsibilities and interests among various health service organizations within a medical alliance, and all people and property implement unified operational management; The semi-compact medical alliance refers to an operational management mode formed by the contract or agreement from the core hospital to the primary health center on the basis that the nature of the assets of various medical service institutions does not change in the medical alliance; Loose medical alliance means that all kinds of health service organizations in the medical alliance only cooperate in medical technology, personnel training, equipment and other aspects. However, various medical and health institutions within the medical alliance are not affiliated. The medical alliance is an important carrier of hierarchical medical system. Its establishment is an effective exploration and practice mode to optimize the allocation of medical resources, improve the service level of primary medical institutions, control the cost of medical and pharmaceutical services, improve the patient experience, and comprehensively improve the health management level and chronic disease management level [2, 3]. The structure, process, and outcome of medical services involve multiple subjects such as patients, doctors, hospitals, government, and society. This places high demands on the allocation of medical resources. This is a comprehensive governance process. However, as the medical service environment becomes more and more complex, the traditional medical service organization mode can no longer meet the requirements of modern medical services for efficiency and social responsibility [4]. Due to the increase in medical risks and the pressure on the medical service market, integrated delivery networks INTEGRATED CARE CASE

[Background]: Improvement of synergies in medical and nursing services can help governments to optimize the allocation of medical resources; however, an appropriate evaluation method is critical for a suitable decision process in this regard. [Method]: To assess the medical and nursing service combination (MNSC) at a regional level, this study applied a five-dimension evaluation index composed of 28 basic response areas related to the MNSC development status in China, determining its respective weight through the Delphi and entropy methods. [Result]: This empirical exercise analyzed the MNSC supply system by interviewing nine heads of medical and nursing institutions and eleven healthcare-related government personnel during August of 2020 in Xinxiang City, Henan province, P.R China. Results showed: (1) public satisfaction with the fees charged by Medical and Nursing service Institutions (MNSI); (2) Medicare and supply services’ policy publicity; (3) the external financing situation of MNSI; (4) the medical staff’s professional quality; (5) the medical facilities and supply of MNSI; and (6) that the recognition level of the development plan of MNSI scored the highest effect on the synergy of MNSC supply among the assessed factors. [Conclusion]: These results showed that an evaluation based on the Delphi and entropy methods can effectively integrate the opinions of experts and related institutions to evaluate synergies on the medical and nursing service supply.

BackgroundImproved of synergies on medical and nursing services can help governments to optimize the allocation of medical resources, however, an appropriate evaluation method is critical for an appropriate decision process in this regard. MethodTo assess medical and nursing service combination (MNSC) at regional level, this study applied a 5-dimension evaluation index composed by 28 basic response areas related to the MNSC development status in China determining its respective weight through Delphi and entropy method.ResultThis empirical exercise analyzed the MNSC supply system by interviewing 9 head of medical and nursing institutions and 11 healthcare-related government personnel during august of 2020 in Xinxiang City, Henan province, P.R China. Results showed that (1) public satisfaction with the fees charged by Medical and Nursing service Institutions (MNSI); (2) Medicare and supply services policy publicity; (3) external financing situation of MNSI, (4) medical staff professional quality; (5) medical facilities and supply of MNSI; and (6) recognition level of the development plan of MNSI scored the highest effect on the synergy of MNSC supply among the assessed factors. ConclusionThese results showed that an evaluation based on Delphi and Entropy Method can effectively integrate the opinions of experts and related institutions to evaluate synergies on medical and nursing service supply.