Abstract
In most countries, the demand for integrated care for people with chronic diseases is increasing as the population ages. This demand requires a fundamental shift of health-care systems towards more integrated service delivery models. To achieve this shift in China, the World Health Organization, the World Bank and the Chinese government proposed a tiered health-care delivery system in accordance with a people-centred integrated care model. The approach was pioneered in Luohu district of Shenzhen city from 2015 to 2017 as a template for practice. In September 2017, China’s health ministry introduced this approach to people-centred integrated care to the entire country. We describe the features of the Luohu model in relation to the core action areas and implementation strategies proposed and we summarize data from an evaluation of the first two years of the programme. We discuss the challenges faced during implementation and the lessons learnt from it for other health-care systems. We consider how to improve collaboration between institutions, how to change the population’s behaviour about using community health services as the first point of contact and how to manage resources effectively to avoid budget deficits. Finally, we outline next steps of the Luohu model and its potential application to strengthen health care in other urban health-care systems.
Highlights
On 1 September 2017, China’s health ministry introduced a new approach to people-centred integrated care to the entire country.[1]
Called the Luohu model, the approach was pioneered in Luohu district of Shenzhen city
The government of Shenzhen city and Luohu district were concerned about the unmet needs of the population and the increased health expenditure associated with inappropriate hospital use and lengths of stay
Summary
On 1 September 2017, China’s health ministry introduced a new approach to people-centred integrated care to the entire country.[1] Called the Luohu model, the approach was pioneered in Luohu district of Shenzhen city. This development was a response to the problems faced by the existing health-care system in addressing the increased demands of delivering integrated care.[2,3] Health-care systems worldwide are facing similar problems emerging from epidemiological transition and population ageing.[4,5,6] Many people-centred integrated care programmes have been initiated, implemented and evaluated in high-income countries. We provide suggestions on adapting the Luohu model in other low- and middle-income countries
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