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Construction and Practice of the County Integrated Healthcare System in China: A Case Study of Shaxian, Sanming Cover

Construction and Practice of the County Integrated Healthcare System in China: A Case Study of Shaxian, Sanming

Open Access
|Aug 2026

References

  1. Correia de Matos R, do Nascimento G, Campos Fernandes A Integrated care: an insight into the national models and their impact on patients and health systems – a narrative review. Journal of Integrated Care. 2025;33(1):6374. DOI: 10.1108/JICA-08-2024-0047
  2. Goodwin N. Understanding integrated care: a complex process, a fundamental principle. International Journal of Integrated Care. 2013;13:e011. DOI: 10.5334/ijic.1144
  3. Hughes G, Shaw SE, Greenhalgh T. Rethinking integrated care: a systematic hermeneutic review of the literature on integrated care strategies and concepts. The Milbank Quarterly. 2020;98(2):446492. DOI: 10.1111/1468-0009.12459
  4. Maeda JLK, Lee KM, Horberg M. Comparative health systems research among Kaiser Permanente and other integrated delivery systems: a systematic literature review. The Permanente Journal. 2014;18(3):6677. DOI: 10.7812/TPP/13-159
  5. Porter M, Kellogg M. Kaiser Permanente: an integrated health care experience. Revista de Innovación Sanitaria y Atención Integrada. 2008;1(1):18.
  6. Green A, Ross D, Mirzoev, T. Primary health care and England: the coming of age of Alma Ata? Health Policy. 2007;80(1):1131. DOI: 10.1016/j.healthpol.2006.02.007
  7. Ye JF, Jiang X, Jing Q, et al. International comparative study of integrated healthcare systems and policy implications. Management Review. 2019;31(6):199212. [in Chinese].
  8. Nurjono M, Yoong J, Yap P, et al. Implementation of integrated care in Singapore: a complex adaptive system perspective. International Journal of Integrated Care. 2018;18(4):4. DOI: 10.5334/ijic.4174
  9. Tsutsui T. Implementation process and challenges for the community-based integrated care system in Japan. International Journal of Integrated Care. 2014;14:e002. DOI: 10.5334/ijic.988
  10. Tao W, Zeng Z, Dang H, et al. Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China. BMJ Global Health. 2020;5(3):e002087. DOI: 10.1136/bmjgh-2019-002087
  11. Ke X, Zhang L, Tang W. Evolutionary trends in integrated care in 2000–2020 in China: a scientometric review using CiteSpace. International Journal of Integrated Care. 2022;22(3):22, 112. DOI: 10.5334/ijic.6006
  12. General Office of the State Council of the People’s Republic of China. Guiding opinions on promoting the construction and development of medical consortia. https://www.gov.cn/gongbao/content/2017/content_5191699.htm (accessed 15 May 2025). [in Chinese].
  13. Zhao LN, Liu BQ, Liu SB, et al. Discussion on the current situation and prospect of compact county medical community in China based on typical cases. Chinese Journal of Hospital Administration. 2022;38(3):161167. [in Chinese].
  14. Zhao MJ, Jia M, Wang F, et al. Measures and effects of the pilot of county-based healthcare network in Deqing county of Zhejiang province. Chinese Journal of Health Policy. 2019;12(11):5358. [in Chinese].
  15. Zhang ZX, Yin G, Bian Y, et al. The synergistic mechanism of capitation prepayment and DRG payment in compact county-level medical consortium: from the perspective of holistic governance. Chinese General Practice. 2025;28(19):24412448. [in Chinese]. DOI: 10.12114/j.issn.1007-9572.2024.0535
  16. Zheng DX, Tian ZW, Dai XZ, et al. Financial Management and Accounting of Countywide Medical Community: Policy Review, Typical Experience and Inspiration. Chinese Health Economics. 2021;40(3):8994. [in Chinese].
  17. Cui ZH, Wang HF, Zhang ZN. Governance mechanism and organizational collaboration of county medical community from the perspective of multiple institutional logics: Theoretical mechanism and empirical test. Chinese Journal of Health Policy. 2025;18(1):29. [in Chinese].
  18. Ye Y, Evans R, Jing L, et al. The Impact of County Medical Community Reform on the Medical Service Efficiency of County-Level Public General Hospitals in China: A Case Study of Shanxi Province. International Journal of Environmental Research and Public Health. 2022;19(21):13827. DOI: 10.3390/ijerph192113827
  19. Zhang L, Yu X, Fang Y. Does Global Budget promote the construction of integrated healthcare delivery system? Evidence from Sanming, China. BMC Public Health. 2025;25:2418. DOI: 10.1186/s12889-025-23018-2
  20. Dong C, Liu J, Mi J. Information-Driven Integrated Healthcare: An Analysis of the Cooperation Strategy of County Medical Community Based on Multi-Subject Simulation. Healthcare (Basel). 2023;11(14):2019. DOI: 10.3390/healthcare11142019
  21. Xu W, Zhu L, Peng Z, et al. A multi-case study of the vertically integrated health-care at county-level in rural China: towards holistic and dynamic governance. Frontiers in Public Health. 2024;11:1178179. DOI: 10.3389/fpubh.2023.1178179
  22. Wan XY, Lin FC, Zhang Y. The role of C-DRG in the reform and development of public hospitals from the perspective of general hospitals. Chinese Health Economics. 2022;41(1):4548. [in Chinese].
  23. Lan Z, Liu J, Chen HW, et al. Research on promoting chronic disease management through the integration of medical care and prevention in compact county medical communities: a case study of Sanming City, Fujian Province. Health Economics Research. 2024;41(11):7477. [in Chinese].
  24. World Health Organization. Framework on integrated, people-centred health services: report by the Secretariat. Document A69/39. Geneva: World Health Organization; 2016. https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_39-en.pdf (accessed 25 May 2026).
  25. Huang Y, Zhu P, Chen L, Wang X, Valentijn P. Validation of the care providers version of the Rainbow Model of Integrated Care-measurement tool in Chinese primary care systems. BMC Health Services Research. 2020;20:727. DOI: 10.1186/s12913-020-05562-2
  26. Shaxian District Government Office. Basic information about Shaxian District. https://www.fjsx.gov.cn/zjsx/sxgk/201611/t20161102_508778.htm (accessed 18 May 2026). [in Chinese].
  27. Statistics Bureau of Shaxian District, Sanming City. 2024 statistical bulletin on national economic and social development of Shaxian District. https://www.fjsx.gov.cn/zwgk/tjxx/tjgb/202504/P020250411536626521262.pdf (accessed 18 May 2026). [in Chinese].
  28. Shaxian District Development and Reform Bureau. Report on the implementation of the 2024 national economic and social development plan and the draft 2025 national economic and social development plan of Shaxian District, Sanming City. https://www.fjsx.gov.cn/zwgk/ghjh/shfzbg/202501/t20250109_2093228.htm (accessed 15 September 2025). [in Chinese].
  29. Shaxian District Health Bureau of Sanming City. 2024 final accounts of the Health Bureau of Shaxian District, Sanming City. https://www.fjsx.gov.cn/zwgk/czzj/bmczyjssgjf/czjs/202508/P020250825590669232442.pdf (accessed 15 September 2025). [in Chinese].
  30. Sanming Daily. Bringing reliable healthcare to people’s doorsteps. https://wjw.fujian.gov.cn/xxgk/gzdt/mtbd/202407/t20240730_6491373.htm (accessed 15 May 2025). [in Chinese].
  31. Wang YP, Li JN, Chen, SS. Unveiling the experience of Shaxian General Hospital in building a county-level medical community. Zhongguo Nongcun Weisheng. 2021;13(7):46. [in Chinese].
  32. Crowe S, Cresswell K, Robertson A, et al. The case study approach. BMC Medical Research Methodology. 2011;11:100. DOI: 10.1186/1471-2288-11-100
  33. Yang X, Chen Y, Li C, et al. Effects of medical consortium policy on health services: an interrupted time-series analysis in Sanming, China. Frontiers in Public Health. 2024;12:1322949. DOI: 10.3389/fpubh.2024.1322949
  34. Zhong ZD, Yang XD, Wu DW, et al. Collaborative governance model and effect analysis of the reform of county medical alliance payment method in Sanming: taking Youxi General Hospital as an example. Chinese Journal of Health Policy. 2022;15(3):18. [in Chinese]. DOI: 10.3969/j.issn.1674-2982.2022.03.001
  35. Wang FC, Wan XY, Chen XT, et al. The “Sanming Model” of human resource management in county medical communities: management practices of Shaxian General Hospital in Sanming City. China Health Human Resources. 2022;(12):2123. [in Chinese].
  36. Fu HQ, Li L, Li MQ, et al. An evaluation of systemic reforms of public hospitals: the Sanming model in China. Health Policy and Planning. 2017;32(8):11351145. DOI: 10.1093/heapol/czx058
  37. Jiang B, Zhou RJ, Feng XL. The impact of the reference pricing policy in China on drug procurement and cost. Health Policy and Planning. 2022;37(1):7399. DOI: 10.1093/heapol/czab012
  38. Zhong Z, Yao Q, Chen S, Jiang J, Lin K, Yao Y, Xiang L. China Promotes Sanming’s Model: A national template for integrated medicare payment methods. International Journal of Integrated Care. 2023;23(2):15. DOI: 10.5334/ijic.7011
  39. Xu J, Zhou Y, Liu R, Cheng F, Liang W. Primary health institutions and service quality in China: implications for health policy. International Journal of Environmental Research and Public Health. 2022;19(19):12063. DOI: 10.3390/ijerph191912063
  40. Barbazza E, Tello JE. A review of health governance: definitions, dimensions and tools to govern. Health Policy. 2014;116(1):111. DOI: 10.1016/j.healthpol.2014.01.007
  41. Guo BQ, Wang HF. Motivation and model choosing of medical alliance establishment based on resource dependent theory. Chinese Hospital Management. 2019;39(8):14. [in Chinese].
  42. Satylganova, A. Integrated care models: an overview. Copenhagen: WHO Regional Office for Europe; 2016.
  43. Juhnke, C. Clinical and service integration. The route to improved outcomes. International Journal of Integrated Care. 2012;12:e199. DOI: 10.5334/ijic.1065
  44. Lin K, Liu X, Xiang L, Luo F. Sanming Model of Medical Service Integration: Impact on medical expenditures, service provision, and resource allocation in China. Risk Management and Healthcare Policy. 2025;18:205216. DOI: 10.2147/RMHP.S503613
  45. Tu WJ, Zhong SF, Liu YK, Zhan J, Liu Q. The Sanming Three-in-One Model: A potentially useful model for China’s systemic healthcare reform. Journal of the American Geriatrics Society. 2019;67(10):22132215. DOI: 10.1111/jgs.16100
DOI: https://doi.org/10.5334/ijic.9542 | Journal eISSN: 1568-4156
Language: English
Page range: 10 - 10
Submitted on: Mar 12, 2025
Accepted on: Aug 5, 2026
Published on: Aug 18, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services

© 2026 Lina Zhao, Yiyang Chen, Fanyi Kong, Zhiyi Luo, Yazi He, Zongjiu Zhang, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.