Continuity-fragmentation-integration：Historical review of health service delivery modes from three-level health service networks in rural China
10.3969/j.issn.1674-2982.2014.12.005
- VernacularTitle:连续-碎片-整合--我国农村三级医疗卫生网络服务提供模式的历史演变及启示
- Author:
Lai WEI
- Publication Type:Journal Article
- Keywords:
Primary care;
Continuity of health service;
Primary health institutions;
Rural health policy;
Political vulnerability
- From:
Chinese Journal of Health Policy
2014;(12):24-30
- CountryChina
- Language:Chinese
-
Abstract:
Over the last several decades, the government’s health decision-making consciousness has change as result of huge economic and social changes thereby resulting in obvious volatility in the continuity of health service de-livery from China’s rural health service network:In the planned economy era. , the rural service mode of“classifica-tion and division of medical institutions and local doctors for local patients” was a starting point for the initial practice of health services continuity;however, following market reforms, rural China has adopted a discrete service mode of“patients freely choosing their doctors, and a fragmentation of provision”;after 2009, with the implementation of the equalization of primary public health service, rural health services exhibited a development trend towards a service mode of “medical treatment at primary health institutions, continuity and comprehensiveness of service provisions”. The volatility of service provision modes in the above three stages indicates a deep influence on the government’s un-derstanding of health service governance at different periods and fully demonstrates that primary care services have ob-vious political vulnerability. These policy motivations behind the characteristics of historical evolution provide many policy experiences of enlightenment for all countries, particularly for the health networks of transitioning nations. To maintain health service continuity, importance must be attached to basic health care strategies, a complete, integrat-ed grassroots health system framework and systematic operation mechanisms must be established and attention must be given to the service concept of people-centered services.
