Figure 1
Timeline of the Luohu reform.
Figure 2
Organizational structure of the Luohu hospital group.
Figure 3
Strategies for an integrated care system in Luohu.
Table 1
Evaluation results of the Luohu model.
| First-level indicator | Second-level indicator | Third-level indicator | Jun 2014–Jun 2015 | Jun 2015–Jun 2016 | Jun 2016–Jun 2017 | |
|---|---|---|---|---|---|---|
| Structure | Area of CHS* | Average area of CHS* (m2) | 410 | 749.5 | 903 | |
| Assets of CHS* | Assets of equipment of all CHSs* (million, $) | 2.76 | 3.50 | 4.09 | ||
| Human resources of CHS* | No. of general practitioners | 89 | 147 | 194 | ||
| No. of physicians providing public health services | 2 | 4 | 30 | |||
| No. of specialists setting up practices in CHSs* | 0 | 0 | 49 | |||
| No. of family doctor teams | 0 | 198 | 238 | |||
| Process | Utilization of general practitioners | No. of residents registered with general practitioners | 0 | 0.15 | 0.58 | |
| Proportion of residents registered with general practitioners (%) | 0 | 12.5 | 38.7 | |||
| Utilization of inpatients | No. of inpatients in the hospital group | 3021 | 5434 | 7034 | ||
| Proportion of inpatients hospitalized in the hospital group compared with all registered inpatients (%) | 15.3 | 19.3 | 21.9 | |||
| Utilization in CHS* | No. of outpatients served by CHSs (million) | 0.795 | 2.02 | 2.25 | ||
| Percentage of CHSs’* patients of all patients in the group (%) | 29.49 | 36.87 | 4260 | |||
| Two-way referral | No. of down-referral patients | 0 | 4365 | 5647 | ||
| No. of up-referral patients | 1442 | 3084 | 4937 | |||
| Outcome | Case Management | No. of patients with diabetes under case management | 5624 | 8210 | 10220 | |
| Proportion of diabetes patients under case management (%) | 66.88 | 67.23 | 69.54 | |||
| No. of patients with hypertension under case management | 19667 | 22579 | 24662 | |||
| Proportion of hypertension patients under case management (%) | 65.5 | 66.0 | 68.2 | |||
| No. of patients with severe mental illness under case management | 1113 | 1402 | 1335 | |||
| Proportion of patients with severe mental illness under case management (%) | 10.6 | 11.2 | 11.8 | |||
| Incidence and mortality | Incidence of infectious disease (1/100,000) | 351.5 | 350.7 | 300.4 | ||
| Mortality rate under 5 (‰) | 2.5 | 2.4 | 1.3 | |||
| New cases of pneumonia | 734 | ** | 511 | 283 | ||
| New cases of cancer | 631 | ** | 590 | 523 | ||
| Patients’ experience | Rank of patients’ satisfaction among ten districts in Shenzhen City | Second | First | First | ||
| Cost | Cost of all types of health care for each registered resident in the group | – | $675.3 | $844.2 | ||
[i] *CHS is short for community health station.
**Time period of the data is from Jun 2014 to Dec 2015.