Abstract
BackgroundOur study aimed to design a tool of evaluating intersectional collaboration on Non-communicable Chronic Disease (NCD) prevention and control, and further to understand the current status of intersectional collaboration in community health service institutions of China.MethodsWe surveyed 444 main officials of community health service institutions in Beijing, Tianjin, Hubei and Ningxia regions of China in 2014 by using a questionnaire. A model of collaboration measurement, including four relational dimensions of governance, shared goals and vision, formalization and internalization, was used to compare the scores of evaluation scale in NCD management procedures across community healthcare institutions and other ones. Reliability and validity of the evaluation tool on inter-organizational collaboration on NCD prevention and control were verified.ResultsThe test on tool evaluating inter-organizational collaboration in community NCD management revealed a good reliability and validity (Cronbach’s Alpha = 0.89,split-half reliability = 0.84, the variance contribution rate of an extracted principal component = 49.70%). The results of inter-organizational collaboration of different departments and management segments showed there were statistically significant differences in formalization dimension for physical examination (p = 0.01).There was statistically significant difference in governance dimension, formalization dimension and total score of the collaboration scale for health record sector (p = 0.01,0.00,0.00). Statistical differences were found in the formalization dimension for exercise and nutrition health education segment (p = 0.01). There were no statistically significant difference in formalization dimension of medication guidance for psychological consultation, medical referral service and rehabilitation guidance (all p > 0.05).ConclusionThe multi-department collaboration mechanism of NCD prevention and control has been rudimentarily established. Community management institutions and general hospitals are more active in participating in community NCD management with better collaboration score, whereas the CDC shows relatively poor collaboration in China.Xing-ming Li and Alon Rasooly have the same contribution to the paper.Xing-ming Li and Alon Rasooly listed as the same first author.
Highlights
Our study aimed to design a tool of evaluating intersectional collaboration on Non-communicable Chronic Disease (NCD) prevention and control, and further to understand the current status of intersectional collaboration in community health service institutions of China
The rising of NCD in China In recent 40 years, China has gone through fast social and economical transformations, including industrialization, urbanization, and aging, which contribute to the rising number of Chinese people with Non-communicable Chronic Disease (NCD), and today the number of persons diagnosed with NCD is estimated at above 260 million [1, 2]
As the primary health care institutions for NCD prevention and control run by governments, Community Health Service Institutions (CHSI) play an impoartant role in offering basic medical and public health services, which are regarded as the basic networks for medical treatment and public health to inhabitants of administrative area, and the main nonprofit primary institutions for NCD management, CHSI shall: "(1) perform regular monitoring and follow-ups on high-risk groups detected during physical examinations and screening, and implement targeted interventions and reduce morbidity risks, (2) strengthen management and services for patients with hypertension, diabetes, chronic obstructive pulmonary disease and other NCD, (3) provide follow-up and rehabilitation guidance for cancer patients,(4) be responsible for the execution and implementation of NCD prevention and control measures."
Summary
Our study aimed to design a tool of evaluating intersectional collaboration on Non-communicable Chronic Disease (NCD) prevention and control, and further to understand the current status of intersectional collaboration in community health service institutions of China. As the other developing countries, tobacco use, foods high in saturated and trans fats, salt, and sugar, physical inactivity, and the harmful consumption of alcohol all serve as the underlying causes of NCD [3]. These modifiable risk factors disproportionately affect individuals with NCD among lower socio-economic groups and further perpetuate health and economic inequalities [4]. The Center of Disease Control (CDC) of local community shall: "(1) develop and promote appropriate technologies to detect high-risk groups, strengthen lifestyle intervention, provide supervision and conduct evaluation, (2) set up specialized departments and designate personnel to conduct NCD prevention and treatment.". Its role in the management of chronic diseases is to make full use of mass media to widely publicize the knowledge of NCD prevention and encourage people to consciously cultivate good habits and lifestyle
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