Exploration into the Collaborative Medical Care to Stimulate the Two-level Cooperation in Xixian, China

Abstract

Objective: To establish the disease-based two-level collaborative medical care to promote the integration of services across the county hospital and township hospital [1]. Methods: The pilot reform was carried out in 2 counties in Henan Province from June 2012, based on the diagnosis and treatment of Cerebral Infarction, Appendicitis, Varicose Great Saphenous Vein and Type 2 Diabetes, 4 continuous clinical pathways across levels was developed, patients with the 4 diseases could get a series of continuous services from two levels institutions in quota payment. The average length of stay (ALOS) and total costs of patients in the after 1 year in the 2 counties were investigated in July 2013. Results: The ALOS of the 4 diseases shortened by an average 4 days in county hospitals, costs decreased 17%, hospital volume increased 18.4%. The hospital volume increased by 7%, the utilization rate of beds increased 27% in township hospitals. The patients' average hospital costs decreased by 5%, the ALOS stayed unchanged. Conclusion: Collaborative Medical Care has promoted residents to seek medical service in order[2], and has no lowered the quality of patient care while reducing hospital costs[3], while it is significant that the efficiency of two levels institutions were improved[4, 5].