JMIR Publications

ABSTRACT

Background:

As China experiences urbanization and an aging population, the need for integrated healthcare has become increasingly important. In response, the Chinese government has proposed the development of an integrated health management system (IHMS), which aims to unite all health-related institutions under a health-centered organizational framework. This shift towards a "health-centered" approach is intended to replace the traditional "treatment-centered" model. The implementation of the IHMS has become a regular process, but it has also encountered several challenges.

Objective:

The purpose of this article is to provide a comprehensive understanding of China's IHMS policy, including its characteristics, development, and evolution. The article also aims to offer reference points for the design and improvement of the system.

Methods:

This study utilizes content analysis methodology to examine relevant policy documents gathered from the Bailu Thinktank and government websites. The search terms used included "healthy China," "medical association," and others. A six-dimensional framework was developed to study the policy documents from the perspective of policy tools and policy orientation. The framework includes policy level, policy nature, release time, policy tools, stakeholders, and policy orientation.

Results:

The analysis reveals that China's IHMS policy is more likely to use environment-based policy tools, which suggests a need for further balance in the internal structure of policy tools. Shanghai's IHMS policy employs the fewest supply-based policy tools, whereas the national IHMS policy and those of other provinces and cities utilize more supply-based tools. The national IHMS strategy places more emphasis on the construction of "smart healthcare," while Shanghai is a leader in the development of "healthy communities" and "healthy China." The growth of China's IHMS policy can be divided into three stages: the "disease-centered period" (2014-2017), the "e-health technology development period" (2017-2019), and the "health-centered period" (2018-2021).

Conclusions:

Based on the analysis, the supply-based policy tools in China's IHMS policy framework should be strengthened, while demand-based policy tools should be maintained, and environment-based policy tools should be appropriately curtailed. Governments at all levels should respond to the central government's policy tools strategy and work to reduce the current system's absurdity. The future policy priority of the Chinese government is the development of healthy communities and a healthy China, and this should be fully considered. The Chinese government should focus on integrating horizontal and multidimensional medical resources by starting with the community. The vital role of primary care doctors should be highlighted, and e-health technology should be utilized to provide comprehensive health services to the entire nation.