Impacts and driving pathways of community-and home-based integrated health and social care on chronic disease management efficiency under integrated long-term care systems
10.3969/j.issn.1674-2982.2025.08.005
- VernacularTitle:整合型长期照护体系下社区居家医养结合服务对慢病管理效率的影响及驱动路径研究
- Author:
Rong CHEN
1
;
Jun ZHAO
;
Si-qi LIU
;
Fang WANG
Author Information
1. 中国医学科学院北京协和医学院医学信息研究所 北京 100020
- Publication Type:Journal Article
- Keywords:
Community-and home-based;
Integrated health and social care;
Chronic disease management;
Efficiency;
Data envelopment analysis;
Qualitative comparative analysis
- From:
Chinese Journal of Health Policy
2025;18(8):38-45
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influencing mechanisms and driving pathways of chronic disease management efficiency for older adults under community-and home-based integrated health and social care.Methods:Guided by the Framework for Countries to Achieve an Integrated Continuum of Long-term Care and the Integrated Care for Older People framework,35 cities/counties/districts from eastern,central,and western China were selected.Data envelopment analysis(DEA)was employed to evaluate comprehensive efficiency,complemented by fuzzy-set qualitative comparative analysis(fsQCA)to identify conditional configurations of high-and low-efficiency pathways.Results:DEA identified six of the 35 regions(17.1%)as DEA-efficient(θ=1,S-/S+=0).fsQCA identified three high-efficiency pathways and four low-efficiency pathways.Governance mechanisms emerged as the core condition across all high-efficiency pathways.Low-efficiency pathways exhibited systemic deficiencies,including governance gaps,fragmented financing,and inadequate health information systems.Conclusion:Under integrated long-term care,governance systems form the cornerstone for enhancing chronic disease management efficacy.Cross-sectoral collaboration is critical to institutional integration,while dynamic resource allocation can mitigate technical limitations.Sustainable financing and interoperable health information systems are pivotal to addressing regional disparities.
