Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 12;24(1):101.
doi: 10.1186/s12939-025-02468-5.

Patient-centered evaluation of integrated care and health equity: evidence from county medical alliances in Henan province

Hengkui Cao  1 , Gang Yin  1 , Xinyu Bao  1 , Hongbing Tao  2   3
Affiliations

Patient-centered evaluation of integrated care and health equity: evidence from county medical alliances in Henan province

Hengkui Cao et al. Int J Equity Health. .

Abstract

Background: Integrated care services have been initiated in China for several years, yet there remains a dearth of substantial evidence and research elucidating the service's efficacy, particularly in underdeveloped areas. This study aims to address this gap by evaluating the effectiveness of integrated care from the patients' perspective, thereby offering practical strategies to improve service effectiveness and promote health equity within county medical alliances.

Methods: The Patient Perceptions of Integrated Care (PPIC) and European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5 L) scales were employed to gather information on patients' perceptions of integrated care and their self-rated health status. A total of 1093 respondents from two pilot areas were selected for data collection. T-tests and one-way analysis of variance (ANOVA) were recruited, additionally, the study utilized multiple linear regression models to examine the specific impact of various factors on the effectiveness of integrated care services.

Results: The average score for the effectiveness of integrated healthcare services from the patients' perspective was 67.72 (SD = 14.443, n = 1093). Statistical analysis revealed that as the respondents' age increased and their self-rated health declined, the PPIC scores showed an upward trend. Regression analysis found that factors such as age, education level, income, health status, and level of healthcare intervention significantly influenced PPIC scores. Overall, there is a trend where respondents with higher health needs tend to have higher perceptions of the service, while those with relatively higher socioeconomic status are more likely to provide lower ratings. Additionally, increasing the frequency and duration of healthcare interventions can improve respondents' evaluations of the services.

Conclusions: This study analyzes the effectiveness of integrated services in China's county-level medical alliance from the patients' perspective. It finds progress in resource integration and efficiency but identifies limitations in implementation, particularly in balancing equity. Socio-economic factors continue to affect the fairness of service utilization and patient satisfaction. Constraints in finance, human capital, and technology hinder the provision of more targeted services for vulnerable groups. To promote health equity, future services need to focus more on key populations and provide more targeted services, accelerate the integration of information technology, and expand service coverage to address the diverse needs of marginalized communities.

Keywords: County medical alliances; Effectiveness evaluation; Health equity; Integrated care; Patient-centered.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the principles established in the Declaration of Helsinki. It primarily focused on patients’ perceptions of integrated care services, with participation being entirely voluntary and anonymous during data collection. Hence, formal approval from the ethical review authority was deemed unnecessary. We ensured that informed consent was obtained from all participants, and strict measures were taken to maintain the confidentiality of participant data throughout the research process. All surveys received approval from School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Comparison between health status and effectiveness of PPIC across different age categories
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Beaglehole R, Epping-Jordan J, Patel V, Chopra M, Ebrahim S, Kidd M, Haines A. Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care. Lancet. 2008;372(9642):940–949. https://www.sciencedirect.com/science/article/pii/S014067360861404X. - PubMed
    1. Yip W, Fu H, Chen AT, Zhai T, Jian W, Xu R, Pan J, Hu M, Zhou Z, Chen Q. 10 Years of health-care reform in China: progress and gaps in universal health coverage. Lancet. 2019;394(10204):1192–1204. https://www.sciencedirect.com/science/article/pii/S0140673619321361. - PubMed
    1. Prince MJ, Wu F, Guo Y, Robledo LMG, O’Donnell M, Sullivan R, Yusuf S. The burden of disease in older people and implications for health policy and practice. Lancet. 2015;385(9967):549–562. https://www.sciencedirect.com/science/article/pii/S0140673614613477. - PubMed
    1. Hsiao WC, Yip W. Financing and provision of healthcare for two billion people in low-income nations: is the cooperative healthcare model a solution?SOC SCI MED. 2024; 345:115730. 10.1016/j.socscimed.2023.115730. - PubMed
    1. Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, Mossialos E, Li C, Lu J, Su M. Quality of primary health care in China: challenges and recommendations. Lancet. 2020;395(10239):1802–1812. https://www.sciencedirect.com/science/article/pii/S0140673620301227. - PMC - PubMed

LinkOut - more resources