Early impact of an integrated healthcare model on stakeholders in China

Background/Aims Since 2017, China has been implementing an integrated healthcare system, aiming to expand county hospitals, reduce patient expenses and deliver better care. This study aimed to evaluate the implementation of this model in Dancheng County, using stakeholder theory to analyse the views of all affected parties. Methods Participants living and working in Dancheng County were recruited from several groups, including: government officials, heads of healthcare organisations, healthcare staff, patients and suppliers. Both public and private healthcare institutions were included. Semi-structured interviews were conducted to collect data on participants' experiences and views of the new model. Interviews were recorded, transcribed and analysed using content analysis. Results Government officials and those working in public healthcare institutions were generally positive about the new model, reporting that it improved financial management, allowed more investment in county hospitals and reduced the profit-seeking behaviours of medical institutions. Patients noted good quality care at a reduced cost. However, private institutions and suppliers noted reduced income and increased supervision, which had negatively affected their profits. Conclusions The integrated model has brought several benefits, particularly to public healthcare institutions, staff and patients. This model may help to reduce profit-seeking behaviours in medical institutions. However, further development is needed to assess and mitigate the negative impact on stakeholders.