Table 1
Respondents by level and location.
| LEVEL | ANHUI | FUJIAN |
|---|---|---|
| Policy makers at departments of health and civil affairs | ||
| Provincial | 2 | 2 |
| Municipal | 2/8 (1)* | 4 |
| County/district | 5 | 5 |
| Heads of related institutions | ||
| PHI | 5 | 5 |
| Elderly care institution | 2 | 3 |
| Integrated care institution | 1 | 1 |
| Total | 25 | 20 |
[i] * Notes group interview.
Table 2
Preliminary progress and main challenges of integrated care based on RMIC.
| RMIC | PRELIMINARY PROGRESS | MAIN CHALLENGES |
|---|---|---|
| System integration | – Solid policy basis: policy jointly issued by multiple government authorities. – Political commitment: the steering group on integrated care with the vice mayor as the leader. | Not mentioned. |
| Organizational integration | – Coordination among government agencies by joint policy release. – Inter-agency collaboration among medical institutions and elderly care institutions. – Collaboration between the government and social capital. | – Ineffective coordination among major stakeholders – Resistance of PHIs to transformed into integrated care institutions – Lack of initiative from social capital. |
| Professional integration | – In the form of multi-disciplinary collaboration – Typical examples: a) family doctor teams, neighbourhood committee, daily care staff and informal caregivers; b) physicians, nurses, and caregivers working at integrated institutions or at different medical and elderly care institutions. | – Multi-disciplinary collaboration is still very weak except for the integrated care institutions. |
| Service integration | – Greatly affected by organizational and professional integration. – The elderly living in the integrated care institutions enjoyed higher level of integrated care. – The family doctor contracting service has boosted the integrated care for community-home dwelling elderly. | – The weak capacity of PHIs cannot meet the increasing demand of home-based integrated care. |
| Functional integration | – Financing: financial budget (for beds, operation); covered by medical insurance. – Human resources: a) set up nursing programs and strengthening professional training; b) addressing the bottleneck of promotion; c) encouraging medical staff to practice at multiple institutions. | – Lack of sustainable funding scheme such as long-term care insurance – Low level and slow progress in information integration. – Professional shortage |
| Normative integration | – Social value: a) special attention and priority policies for the elderly in difficulty; b) advocacy of healthy ageing and elderly friendly environment. | – Ineffective integration of current independent service standards and lack of top-level design towards multi-disciplinary service standards. |