Integrated Healthcare Systems Response Strategies Based on the Luohu Model During the COVID-19 Epidemic in Shenzhen, China

Abstract

COVID-19 has affected primary health-care delivery in metropolitan areas. An integrated health-care system offers advantages in response to the community outbreak and transmission of highly infectious diseases. On the basis of practitioner experience with a pioneering integrated health-care system in Shenzhen, China, this article presents the following effective strategies in response to the epidemic: (1) enhance the public workforce in primary health care; (2) integrate resources to allow regional sharing and efficient use; (3) employ teams centered on general practitioners for community containment; and (4) adopt e-health and telemedicine for health-care delivery. An integrated health-care system is usually very specific to a particular regional context; however, the core strategies and mechanisms based on the Luohu model can contribute to improving the public health capacity in emergency responses; they can transform health-care delivery in the COVID-19 epidemic. The experience in Shenzhen may help other cities in enhancing and coordinating the preparedness of their health-care systems in dealing with future public health emergencies.

“We All had to Respond to the Pandemic and our Patient Needs”: Social Workers’ Perspectives of Integrated Healthcare Agencies’ Response to COVID-19 Pandemic

“…Consistent with the literature on organizations making prompt shifts to an alternative mode of care delivery due to the pandemic (Holliday et al, 2020;Mishna et al, 2020;Gong et al, 2021;Rosen et al, 2021;Ross et al, 2021), social workers were also impacted by this transition/response and in how they interacted with patients in integrated healthcare agencies. Specifically, one of the major impacts on social workers in integrated healthcare agencies was the transition to remote work, which is consistent with social workers outside of these settings (Booth et al, 2020;Gergerich et al, 2020).…”

Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings

“…Evidence gathered since the start of the pandemic has shown that the collaborative medical service networks have significantly improved the preparedness and resilience of the health care services, including mobilizing additional financing from PHC-Funds, coordinating medical facilities and supplies, reinforcing the availability of health workers, and, most importantly, maintaining delivery of essential health services in cases where larger hospitals closed their outpatient departments during periods of transmission. Similarly, a study of the Luohu model in Shenzhen, China, supported the finding that the core strategies and mechanisms of an integrated healthcare system can contribute to improving the public health capacity during an emergency response [ 42 ]. The COVID-19 pandemic is revealing serious gaps and vulnerabilities in the health systems of many countries; hence, accessing high-quality PHC is as important as ever [ 13 ].…”

Preparedness, impacts, and responses of public health emergencies towards health security: qualitative synthesis of evidence

“… CAR, Brazil, Malawi, Germany, Cameroon, SSA, Liberia, India Multisectoral actions Linkages between policymakers, community based organisations, NGOs, and private sector [ 13 ], community resilience, satisfaction, and confidence [ 16 , 30 ], Engaging stakeholders in planning [ 52 , 64 ], multisectoral actions for prevention of pandemic [ 54 ], community collaborations [ 30 , 70 ], multi-sectoral and comprehensive provincial pandemic and economy [ 56 ], “One Health” approach [ 29 , 63 ], multisectoral actions for non-health sector response [ 71 ], multisectoral coordination, integration of fragmented approaches [ 72 ]. Israel, Thailand, South Africa, Cuba Communication and partnership Strategic partnerships of international organisations [ 43 , 49 , 73 , 74 ], rebuilding coordination and communication networks, [ 27 , 47 , 67 ], humanitarian response, maintaining and outreach or mobile clinics [ 31 , 42 , 68 ], hospitality towards displaced populations [ 40 ], regional forums, institutions [ 26 , 72 ], global initiatives and cross-country lessons [ 71 , 75 ]. Sierra Leone, China, Italy, Japan, Yemen, Cameroon, Congo, Mali, Nigeria, EMR Use of digital tools systems shift to using new technologies and digital tools [ 26 , 45 , 49 , 50 , 76 ], digital consultation communication in remote consultations [ 53 , 55 , 68 , 76 ...…”

“… Israel, Thailand, South Africa, Cuba Communication and partnership Strategic partnerships of international organisations [ 43 , 49 , 73 , 74 ], rebuilding coordination and communication networks, [ 27 , 47 , 67 ], humanitarian response, maintaining and outreach or mobile clinics [ 31 , 42 , 68 ], hospitality towards displaced populations [ 40 ], regional forums, institutions [ 26 , 72 ], global initiatives and cross-country lessons [ 71 , 75 ]. Sierra Leone, China, Italy, Japan, Yemen, Cameroon, Congo, Mali, Nigeria, EMR Use of digital tools systems shift to using new technologies and digital tools [ 26 , 45 , 49 , 50 , 76 ], digital consultation communication in remote consultations [ 53 , 55 , 68 , 76 ], learning tools [ 60 ], use in data collection and supervision [ 44 ], reached vulnerable groups, optimisation of workers, and telecare [ 50 , 77 – 79 ], set alarm systems, generate real-time, monitoring and evaluation [ 50 , 77 , 78 ], sharing information and communication [ 39 , 80 ], technology informed multidisciplinary care [ 67 ], DigiTech in data processing, research [ 43 , 71 ]. China, Australia, LMICs, Dubai, SSA Multidisciplinary health providers service delivery by CHWs [ 44 , 55 …”

“… Sierra Leone, China, Italy, Japan, Yemen, Cameroon, Congo, Mali, Nigeria, EMR Use of digital tools systems shift to using new technologies and digital tools [ 26 , 45 , 49 , 50 , 76 ], digital consultation communication in remote consultations [ 53 , 55 , 68 , 76 ], learning tools [ 60 ], use in data collection and supervision [ 44 ], reached vulnerable groups, optimisation of workers, and telecare [ 50 , 77 – 79 ], set alarm systems, generate real-time, monitoring and evaluation [ 50 , 77 , 78 ], sharing information and communication [ 39 , 80 ], technology informed multidisciplinary care [ 67 ], DigiTech in data processing, research [ 43 , 71 ]. China, Australia, LMICs, Dubai, SSA Multidisciplinary health providers service delivery by CHWs [ 44 , 55 ], family health teams in flu assessment [ 67 ], VHVs’ role in identification and monitoring of returnees [ 81 ], CHVs’ role in child health services, control of Ebola and malnutrition [ 42 ], integrating health-care system to enhance the public workforce practitioners [ 26 ], redefining training plans for safe working environments [ 51 , 56 , 82 ], intrinsic motivation and self-initiative [ 58 ]. Yemen, SSA, Thailand, China, Malawi, South Africa, Germany Planning for resilient health systems organization and pre-emptive planning [ 52 , 57 , 58 ], context-specific priorities, resilient health infrastructures [ 83 ], ...…”