The Impact of Health Alliance and its Models on the Quality of Primary Care in Urban China: Based on Standardized Patient Approach

Corresponding author: Zhou Zhong-liang, zzliang1981@xjtu.edu.cn

DOI: 10.12201/bmr.202108.00021

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  Abstract: Objective: To evaluate the impact of Health Alliance and its models on the quality of primary care to provide a scientific basis for the improvement of Health Alliance. Methods: Standardized Patient method was employed to collect the data of the primary care quality. Coarsened Exact Matching (CEM) method was employed to match the CHCs that implemented Health Alliance with the unimplemented CHCs, and match the CHCs implemented Tight Health Alliance with Loose Health Alliance, respectively. Difference in difference and multiple regression models were used to evaluate the impact of Health Alliance and its models. Results: After controlling for the potential confounding factors and fixed effects, the Tight Health Alliance increased the clinical adherence rate by 1.35 percentage points (P<0.001), the correct diagnosis by 0.61 percentage points (P<0.05), the rate of unnecessary exams by 1.65 percentage points (P<0.05), the rate of unnecessary drugs by 2.07 percentage points (P<0.05), the consultation time by 0.36 minutes (P<0.05), and the average score of patient-centered communication by 1.35 (P<0.001). Conclusion: Health Alliance and Tight Health Alliance were more likely to improve the quality of primary care. However, the impact is limited because the community of responsibilities and interests has not yet been formed, which makes it difficult to promote the reform of the internal operation mechanism, and can not form a closer resource sharing mechanism. That restricts the close health alliance to paly its advantages.

  Key words: Health Alliance; Tight Health Alliance; Primary Care Quality; Standardized Patient; Difference in difference

  Submit time: 2 November 2021

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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