The effect of the integrated delivery system in rural areas of China.

ABSTRACT

BACKGROUND: With the continuous development of modern society, the management of chronic diseases has become the focus of the medical community in China. In particular, diabetes is a chronic disease that cannot be ignored. China has built an integrated delivery system to deal with imminent health problems. The purpose of this study is to investigate the effects of integrated rural supply system in China. METHODS: We selected 1,061 patients with diabetes from the Zhili Town Health Center's hospital information system. We tracked and studied their outpatient and inpatient expenses, treatment behaviors, incidence of complications, and satisfaction over 5 years. We compared the data collected from 2014 to 2019 to determine the trends of these four factors and the effects of the integrated delivery system for patients with diabetes. RESULTS: We found that the average costs for diabetes patients in outpatient and inpatient departments were increasing slightly every year. The number of patients in tertiary hospitals has decreased significantly, while the number of patients in community hospitals (primary hospitals) has increased, and the number of patients in secondary hospitals has remained relatively unchanged. Meanwhile, the expenses per visit were also lower over this period in hospitals at all levels. Diabetes complications have been increasing marginally, and there is a relatively high degree of satisfaction among patients and doctors in primary hospitals, which is rising. CONCLUSIONS: Considering the various needs of people in different stages of life, the integrated delivery system provides and manages continuous services such as health promotion, disease prevention, diagnosis, treatment, rehabilitation, and management through cooperation between institutions at different levels of the health system.