Human resources for medical and preventive care integration are an important guarantee for the effective implementation of the medical and preventive care integration strategy. Currently, academic research focuses mainly on summarizing medical and preventive care integration practices in various regions, but there is a lack of systematic discussion on the construction of medical and preventive care integration talent teams, which cannot meet the needs of policy optimization and practical implementation.
To analyze the characteristics of China's human resources policies of integrated medical and prevention, and put forward policy suggestions for improvement of manpower.
Using the keywords "integration of medical care and prevention" "combination of prevention and treatment" and "coordination between medical care and prevention" this study searched official websites such as the State Council and the National Health Commission for policy documents related to the research topic, with the search period limited from January 1, 2018 to January 1, 2025. Drawing on human resource management process theory, an analytical framework was constructed, focusing on five sub-themes: talent recruitment, development, incentives, protection, and mobility. The thematic framework analysis method was then applied to analyze the medical-prevention integration human resource policies obtained through the search.
A total of 24 policy documents were included. From the perspective of issuing characteristics, the National Health Commission issued the most documents (17); 10 documents were jointly issued by three or more departments; and the main types of policies were notices (11) and opinions (10). From a content perspective, the policy coverage with the highest proportion of documents was talent development (12), followed by talent recruitment (9), talent incentives (8), talent mobility (8), and talent protection policies (6). Further analysis revealed that the policy measures in each phase were mostly strategic in nature, with common issues including insufficient guidance and lack of detail.
China's manpower policy synergy of integrated medical and prevention services is good, but the systematic and operational nature is poor; policy measures tend to focus on the development of human resources links, and human resources protection policies are insufficient; policy initiatives are mainly unitary, and there is a lack of comprehensive policy strategies. It's recommended that the relevant supporting policies be further refined and perfected, that targeted policies related to medical and defense manpower be formulated in conjunction with the characteristics of the main body of medical and defense integration services, and that the policy on the protection of human resources is continuously improved.
With the continuous advancement of contracted family doctor services, improving service quality has become increasingly challenging. There is an urgent need for cost-effective, operationally feasible, and readily implementable strategies to enhance service delivery.
To evaluate whether a WeChat-based enhanced service package "developed using existing community resources without additional costs" can improve the efficiency and effectiveness of contracted family doctor services.
From May 29 to June 9, 2023, a total of 131 participants were recruited from a family doctor studio at Kangjian Community Health Service Center in Xuhui District, Shanghai. Participants who had WeChat contact with the family doctor were invited to join a dedicated WeChat service group. The enhanced intervention package was delivered via WeChat for 6 months. Before and after the intervention, data were collected on health management service utilization, physician trust (assessed using the revised Wake Forest Physician Trust Scale), and family doctor service cohesion. Multiple linear regression was employed to identify individual-level factors associated with changes in these outcomes.
(1) Health management service utilization and outcomes: after the intervention, the proportions of participants receiving physician/nurse health follow-ups, health record establishment, integrated specialist consultations, and health education services significantly increased; evaluation scores for all these services also improved (P<0.05). (2) Physician trust: total physician trust scores significantly improved after the intervention (P<0.05); among the 10 items, 9 showed significant improvement (P<0.05), with only the item "The physician's skill level did not meet my expectations" showing no significant change (P>0.05). (3) Family doctor service cohesion: Monthly per capita visits to the family doctor increased from 0.43 to 0.62, and the proportion of visits to family doctors rose from 32.30% to 61.01%, while total monthly outpatient visits to the community health center significantly decreased (P<0.05). Regression analysis revealed that the number of chronic diseases and education level were significantly associated with total physician trust scores (P<0.05), while the number of chronic diseases was the primary predictor of changes in monthly family doctor visits (P<0.05).
The "micro" -integration enhanced medical-preventive services package improved contracted residents' evaluation of family doctor services and ultimately increased both the frequency and proportion of visits to family doctors. This preliminary exploration demonstrates the feasibility of a strategy in which family doctors systematically integrate existing service content and deliver structured services in a visualized and intensified manner through an online platform.
The integration of medical care and preventive services is a key strategy in China's response to the growing burden of chronic diseases. However, existing research has predominantly focused on policy design and supply-side reforms, with limited attention to patient-centered demand analysis.
This study aimd to assess the demand for integrated medical care and preventive services among patients with type 2 diabetes and to identify associated factors, providing micro-level empirical evidence to inform policy and research.
A cross-sectional survey was conducted between November 13-15 and December 17-20, 2024, using stratified and random sampling in one county-level city in Shandong Province and one county in the Guangxi Zhuang Autonomous Region. A total of 2 004 patients with type 2 diabetes completed structured questionnaires covering socio-demographic characteristics, health status, healthcare utilization, diabetes-related health literacy, attitudes toward health responsibility, and demand for integrated medical care and preventive services. Multivariate linear regression models were employed to examine factors associated with overall and domain-specific demand.
The mean score for overall demand was (3.99±0.53) on a 5-point scale. Among the three domains, demand was highest for "medical-preventive-managed care" (4.02±0.57), followed by "patient empowerment care" (4.02±0.55), and lowest for "health determinants-focused care" (3.83±0.68). Significant predictors of overall and domain-specific demand included family doctor contract status, familiarity with community or village doctors, satisfaction with patient-centered care, and levels of agreement with personal, provider, and family's responsibility for health (P<0.05). Geographic region, self-rated health status, and quality of life were also significantly associated with all demand but health determinants-focused care (P<0.05). Higher diabetes health literacy was linked to increased demand in all but patient empowerment care (P<0.05). Agreement with fate-based health responsibility was associated with lower demand for medical-preventive-managed care and patient empowerment care (P<0.05).
Patients with type 2 diabetes exhibit strong demand for integrated care and preventive services, particularly for medical-preventive-managed care and patient empowerment care. Policymakers and providers should be attentive to patients' specific demand and service priorities while ensuring adequate attention to relatively underemphasized but essential care targeting health determinants. Interventions to strengthen patients' sense of health responsibility and leverage family doctor contract as a key entry point for integration should be prioritized in future policy design.
