Structural analysis of influencing factors for continuity of care and care coordination:A DEMATEL-AISM approach
10.3969/j.issn.1674-2982.2025.05.002
- VernacularTitle:服务连续性与协调性的影响因素结构分析:基于DEMATEL-AISM法
- Author:
Yan-qiu DU
1
;
Yong-song LUO
;
Jia-yan HUANG
Author Information
1. 复旦大学公共卫生学院 上海 200032
- Publication Type:Journal Article
- Keywords:
Continuity of care;
Care coordination;
Influencing factors;
DEMATEL;
AISM
- From:
Chinese Journal of Health Policy
2025;18(5):6-12
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify key influencing factors and their structural relationships for continuity of care and care coordination in integrated healthcare systems,providing evidence for systemic improvement strategies.Methods:Taking the Yuhuan Health Consortium in Zhejiang Province as an example,this study integrated the Decision-Making Trial and Evaluation Laboratory(DEMATEL)and Adversarial Interpretive Structure Modeling(AISM).An expert questionnaire and literature review were used to construct a factor system,quantifying the influence degree,centrality,and hierarchical structure of 17 continuity and 14 coordination factors.Results:In the system of continuity of care,division-of-labor and linkage mechanisms(influence degree:2.516)and payment methods(causal degree:1.043)were identified as core drivers,forming a four-level interaction network.For care coordination,health planning(centrality:4.452)and health insurance policies(causal degree:1.131)emerged as root causes,establishing a three-tier hierarchical structure.Topological analysis revealed that continuity relies on the"institutional design-process articulation-patient perception"pathway,while coordination depends on the"policy traction-management synergy-technical support"linkage mechanism.Both systems shared disease characteristics(causal degree:1.650/1.384)as underlying drivers,yet service processes(centrality:4.680)and managerial awareness(centrality:4.754)served as unique hub nodes.Conclusion:Differentiated interventions are required:continuity improvement should prioritize payment reform and division-of-labor mechanisms,while coordination enhancement necessitates strengthened health planning and policy synergy.
