Implementation of Integrated Care for the Aged Population in Anhui and Fujian Province of China: A Qualitative Study

Abstract

Introduction: Implementing integrated care for the aged population has been regarded as a mechanism to achieve healthy ageing. However, evidence from undeveloped nations has been scant. This study aims to explore the integrated care experience in Anhui and Fujian Province of China based on the Rainbow Model of Integrated Care (RMIC). Methods: The qualitative study was conducted in Anhui (in the middle area) and Fujian Province (in the eastern area) between May and September in 2018. The interviewees included twenty-eight policy makers working at departments of health and civil affairs at different levels and seventeen heads of medical and elderly care institutions. Results: The preliminary progress of integrated care in the sample cities of two provinces are mainly shown at solid policy basis by multiple key government agencies and political commitment achieved (system integration); preliminary coordination mechanism established between medical and elderly care institutions (organizational integration); consolidation of multi-disciplinary collaboration (professional integration); and reinforced role of family doctor teams for community-home dwelling elderly (service integration). Main challenges are also identified at insufficient inter-agency coordination, weak service capacity, lack of sustainable funding schemes, low level of information integration, and shortage of professional supply. Conclusion: Our findings provide a feasible path for other countries to strengthen integrated care for the aged population, particularly for those confronting rapid population ageing but with fragmented health care and elderly care systems.

Effect of multiple chronic conditions on family doctor contracting in the elderly in China: the moderating role of socioeconomic status

“…The MCCs can harm the physical and mental health of the elderly, with the impact increasing as the degree of MCCs increases [ 39 , 40 ]. FDCSs were helpful to improve the treatment effect of chronic diseases, improve the quality of comprehensive care, and improve the health-related quality of life [ 7 , 9 , 41 , 42 ]. Patients with chronic diseases may also be more willing to use health services to meet their health needs [ 43 , 44 ].…”

“…The FDCSs have a positive effect on residents' health. Yuan et al showed that family doctors can provide high-quality comprehensive care services for the elderly [ 7 ]. The study of Yu et al and Wang et al showed that contracted residents strengthened the monitoring of chronic diseases and increased the utilization of primary care facilities [ 8 , 9 ].…”

Choice Preference of Middle-Aged and Elderly People on Integrated Medical Services and Elderly Care Model: A Cross-Sectional Study

“…Numerous studies explore how the government should optimize this policy from the perspective of policymakers. 12 For example, based on the experience of home elderly care in Japan, some research suggests that China should actively promote long-term care insurance and integrate elderly care service and chronic disease management services. 13 2.…”

Delivering Integrated Community Care for the Elderly: A Qualitative Case Study in Southern China

“…Most studies have been conducted at a strategic macro or national level, focusing on health system and policy implementation. For instance, they have examined integrated care policy implementation [ 23 , 24 , 25 ], primary care, delivery systems, and care coordination at the organizational level [ 26 , 27 ]. However, as highlighted in a review study, the majority of research focuses on coordinating care at the clinical (micro) level and service/organizational (meso) level, with limited exploration of system (macro) level integration and multilevel integrated care approaches [ 28 ].…”