Performances of Integrated Care Organization in Fighting Post-COVID-19 Public Health Crisis: Introduction and Evaluation of the Luohu Model

The Luohu integrated care organization reorganized its care delivery model in less than one week to fight against medical chaos right after quarantine, outperforming other integrated care systems in China; therefore, this study aims to summarize the practice of Luohu model and evaluate its performance. Specifically, we summarized Luohu integrated care organization in reshaping its care delivery model between Dec 9th, 2022 and Jan 19th, 2023 to combat potential medical chaos, and evaluated the performance of Luohu in avoiding infections and medical expenditure savings as compared to normal practices. The study was conducted within the Luohu integrated care organization, recognized as a pioneer in China's integrated care reform, with data collected from a total of 45 Community Health Centers (CHCs) and key healthcare facilities within the district. The study population was not limited by sex or ethnic group. The selection criteria for the healthcare facilities were based on their integration into the Luohu integrated care organization, and there was no exclusion criteria for facilities based on size or type, ensuring a comprehensive assessment of the integrated care system. As primary outcomes, the study assessed changes in visit structure, infections averted, cost savings, and satisfaction levels among both doctors and patients. The results showed that the Luohu model primarily focuses on online medication and drug distribution, training for temporary general practitioners, and establishment of community-based fever clinics. This model averted an average of 490 daily infections per 100,000 people served by the community health center, while also saving $10,736.32. Patient satisfaction with the rapid response services was at 100% (n=209). Additionally, primary care physicians reported a significant increase in workload, necessitating physical and psychological support (n=34). In conclusion, Luohu's success in restoring medical order lies in its integrated management in the usual time and its ability to flexibly restructure under environmental changes, demonstrating that integrated delivery systems have greater potential against emergent medical crises.