Measuring integrated hypertension care in community health centers: a cross-sectional study based on the Rainbow Model of Integrated Care in Chengdu, China

BACKGROUND: Effective hypertension management requires cross-sector coordination. The effectiveness of integrated hypertension care varies due to its multidimensional nature, yet evidence from Chinese primary care is limited. This study assessed the level of integrated hypertension care using the Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) and identified key influencing factors. METHODS: A cross-sectional census was conducted among all community health centers (CHCs) in Chengdu between November 2021 and January 2022. Service integration was evaluated across six dimensions: person-& community-centeredness, care integration, professional integration, organizational integration, cultural competence, and technical competence. Multilevel linear modeling was applied to identify factors associated with integration. RESULTS: Among 110 CHCs surveyed (effective rate: 84.6%), the highest mean integration score was observed in person- & community-centeredness (4.31), whereas organizational integration received the lowest score (2.96). Higher staff education levels (β = - 0.122, 95% CI: - 0.225 to - 0.019), availability of an emergency department (β = - 0.158, 95% CI: - 0.248 to - 0.068), implementation of disease-specific outpatient management (β = - 0.170, 95% CI: - 0.288 to - 0.052), and participation in hospital alliances (β = - 0.217, 95% CI: - 0.421 to - 0.013) were positively associated with greater integration. In contrast, having ophthalmology services (β = 0.110, 95% CI: 0.009 to 0.211) and use of wearable devices (β = 0.204, 95% CI: 0.037 to 0.370) were negatively associated with integration. CONCLUSIONS: Institutional integration of hypertension services among CHCs in Chengdu remains suboptimal, with organizational domains lagging behind person-centered aspects. The findings highlight the necessity of strengthening systemic capacities-particularly in staff training, infrastructure development, and inter-organizational collaboration-to enhance the overall performance of integrated primary care.