Education, Science, Technology, Innovation and Life
Open Access
Sign In
  1. Home
  2. Journals
  3. MEDS Public Health and Preventive Medicine
  4. Vol 5, Issue 2, 2025

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

Download as PDF

DOI: 10.23977/phpm.2025.050209 | Downloads: 4 | Views: 165

Author(s)

Yixin Du 1, Mingyang Li 1, Dachuang Zhou 1, Renwei Gan 1, Xiujuan Cui 1, Zijin Fang 1, Yingjie Yang 1, Ke Wang 1, Tao Wang 1, Jinchun Lin 2, Fangfang Gong 2, Wenxi Tang 1

Affiliation(s)

1 School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, 211198, China
2 Department of General Medicine, Shenzhen Luohu Hospital Group Luohu People's Hospital (the Third Affiliated Hospital of Shenzhen University), Shenzhen, 518001, China

Corresponding Author

Jinchun Lin

ABSTRACT

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.

KEYWORDS

Luohu Integrated Care; Post-COVID-19 Crisis; Infection

CITE THIS PAPER

Yixin Du, Mingyang Li, Dachuang Zhou, Renwei Gan, Xiujuan Cui, Zijin Fang,  Yingjie Yang, Ke Wang, Tao Wang, Jinchun Lin, Fangfang Gong, Wenxi Tang, Performances of Integrated Care Organization in Fighting Post-COVID-19 Public Health Crisis: Introduction and Evaluation of the Luohu Model. MEDS Public Health and Preventive Medicine (2025) Vol. 5: 57-69. DOI: http://dx.doi.org/10.23977/phpm.2025.050209.

REFERENCES

[1] The State Council The People's Republic of China. As of the end of 2016, a total of 205 cities at or above the prefecture level nationwide have launched pilot projects for integrated medical consortia [Webpage on the Internet]. 2017[cited 2024 Dec 4]. Available from: https://www.gov.cn/xinwen/2017-04/14/content_5185777.htm
[2] National Health Commission of The People's Republic of China. Guiding Opinions of the National Health and Family Planning Commission on Carrying Out Pilot Work of Medical Consortium Construction [Webpage on the Internet]. 2017[cited 2024 May 4]. Available from: http: //www. nhc. gov. cn/yzygj/s3594q/201701/4a39ec35c70a4899b3e415b51e821464.shtml
[3] The State Council Of The People's Republic Of China. China has built 4,028 county medical communities. Available from: https://www.gov.cn/xinwen/2021-06/04/content_5615449.htm
[4] The State Council Of The People's Republic Of China. Over the past 10 years, China has formed 15,000 medical consortia of various forms. Available from: https://www.gov.cn/xinwen/2022-09/07/content_5708795.htm
[5] The State Council Of The People's Republic Of China. Guiding Opinions on Comprehensively Promoting the Construction of Close-knit County Medical and Healthcare Communities. Available from: https: //www. gov. cn/zhengce/zhengceku/202312/content_6923447.htm
[6] National Health and Family Planning Commission. Guidelines on the Pilot Work of Establishing Medical Consortiums. 2016. Available from: http://ggzy.guizhou.gov.cn/ztzl/yycgzc/202003/t20200327_55672002.html.
[7] National Health Commission. Interpretation of the Measures for the Administration of Medical Consortium (Trial). 2020. Available from: https://www.gov.cn/zhengce/2020-07/31/content_5531670.htm#:~:text=
[8] People’s Government of Guangdong Province. Shenzhen Luohu District builds medical community model to achieve results will be nationally popularized. [Webpage on the Internet].2017 [cited 2024 May 4]. Available from: https://www. gd.gov.cn/gdywdt/dczl/gcls/content/post_81987.html
[9] Wang, X., Sun, X., Gong, F., Huang, Y., Chen, L., Zhang, Y., & Birch, S. The Luohu Model: A Template for Integrated Urban Healthcare Systems in China. International Journal of Integrated Care, 2018; 18(4): 3, 1–10. 
[10] Gong F, Hu G, Lin H, Sun X, Wang W. Integrated Healthcare Systems Response Strategies Based on the Luohu Model During the COVID-19 Epidemic in Shenzhen, China. International Journal of Integrated Care, 2021; 21(1): 1, 1–7. 
[11] National Health Commission of the People's Republic of China. Release of 35 Major Typical Experiences in Deepening Medical Reform .China: NHC; 2017 June. Available from: http: //www. nhc. gov. cn/wjw/mtbd/201706/685e8b46e2944424a61a9871acf6943c.shtml
[12] Xin W, Xizhuo S, Stephen B, Fangfang G, Pim V, Lijin C, Yong Zh, Yixiang H, Hongwei Y.People-centred integrated care in urban China. Bull World Health Organ, 2018;96(12): 843-852.
[13] Xi L, Harlan MK, Winnie Y, et al. Quality of primary health care in China: challenges and recommendations.The Lancet. 2020;395(10239):1802–12. 
[14] Liang D, Mei L, Chen Y, Zhou P, Yang X, Huang J. Building a people-centred integrated care model in Urban China: a qualitative study of the health reform in Luohu. Int J Integr Care. 2020;20(1):9. 
[15] Comprehensive Group of Joint Prevention and Control Mechanism of the State Council in Response to Novel Coronavirus Pneumonia. Notice on further optimising the implementation of measures to prevent and control the COVID-19 epidemic. [Webpage on the Internet].2022[cited 2024 Jul 30]. Available from:http://www.gov.cn/xinwen/2022-12/07/content_5730475.htm.
[16] National Health Commission. Notice on further optimizing the prevention and control measures of the COVID-19 epidemic. [Webpage on the Internet].[cited 2024 Jul 30].Available from:http://www.nhc.gov.cn/xcs/yqfkdt/202211/ ed9d123bbfe14e738402d846290049ea.shtml.
[17] The State Council Joint Prevention and Control Mechanism. Notice on further optimizing and implementing the prevention and control measures of COVID-19 epidemic 2022[cited 2024 Jul 30]. Available from: http: //www. gov. cn/xinwen/2022-12/07/content_5730443.htm.
[18] The State Council Joint Prevention and Control Mechanism. The joint prevention and control mechanism of the state council announced 20 measures to further optimize epidemic prevention and control. [Webpage on the Internet]. 2022[cited 2024 Jul 30]. Available from: http://www.gov.cn/xinwen/2022-11/11/content_5726144.htm.
[19] The State Council Joint Prevention and Control Mechanism. The state council joint prevention and control mechanism January 19, 2023 press conference transcript [Webpage on the Internet].2023[cited 2024 Jul 30]. Available from: http://www.nhc.gov.cn/xcs/yqfkdt/202301/f9dc81a1ff254460879af4be60f2dd2c.shtml.
[20] Chinese Center for Disease Control and Prevention. Epidemic situation of COVID-19 infection in China. [Webpage on the Internet]. 2023[cited 2024 Jul 30]. Available from: https: //www. chinacdc. cn/jkzt/crb/zl/szkb_11803/jszl_13141/202303/t20230304_264035.html.
[21] "'Tragic Battle': On the Front Lines of China's Covid Crisis". New York Times. 27 December 2022. Available from: https://www.nytimes.com/2022/12/27/world/asia/china-covid-hospital-crisis.html
[22] Che, Chang (25 December 2022). "Covid is Spreading Rapidly in China, New Signs Suggest". The New York Times. Available from:https://www.nytimes.com/2022/12/25/world/asia/covid-spreading-china.html
[23] Fu D, He G, Li H, Tan H, Ji X, Lin Z, Hu J, Liu T, Xiao J, Liang X, Ma W. Effectiveness of COVID-19 Vaccination Against SARS-CoV-2 Omicron Variant Infection and Symptoms - China, December 2022-February 2023. China CDC Wkly. 2023;5(17):369-373. 
[24] Chen J, Feng H, Sun J, Jiang Y. Omicron wave during December 2022 - January 2023: access to pharmaceuticals and healthcare resources and impacts on health outcomes in Shenzhen, China. J Pharm Policy Pract. 2024; 17(1): 2306867. Published 2024 Feb 13. 
[25] In Luohu, the "Bi-weekly Release" special session on development and reform was held, exerting the core engine function of the Greater Bay Area. Shenzhen Luohu Government.[Webpage on the Internet]. 2019[cited 2024 Jul 30]. Available from:http://www.szlh.gov.cn/zwdt/content/post_5254746.html.
[26] Shenzhen Luohu District Statistical Bulletin on National Economic and Social Development for the Year 2022. Shenzhen Luohu Government.[Webpage on the Internet]. 2023[cited 2024 Jul 30]. Available from: https://www. szlh.gov. cn/zwgk/jggk/tjsj/tjgb/content/post_10638019.html
[27] Luohu District Seventh National Population Census Bulletin (No. 6) — On the Situation of the Migrant Population. Shenzhen Luohu Government. 2023[cited 2024 Jul 30]. Available from: http: //www. szlh. gov. cn/zwgk/tjxx/tjgb/content/post_8853293.html.
[28] Gong Fangfang, Sun Xizhuo, Li Yanan. Building a High-Quality Integrated Medical Service System with Chinese Characteristics: A Case Study of the Luohu Hospital Group in Shenzhen [J]. Chinese General Practice, 2021, 24(19): 2408-2411+2417.[In Chinese].
[29] Mingwei F. Challenges and countermeasures for promoting hierarchical diagnosis and treatment after the epidemic. Qilu Journal, 2022(06): 136-147.[in Chinese].
[30] Moon MJ. Fighting COVID-19 with Agility, Transparency, and Participation: Wicked Policy Problems and New Governance Challenges. Public Adm Rev. 2020;80(4):651-656. 
[31] Wernli D, Clausin M, Antulov-Fantulin N, et al. Building a multisystemic understanding of societal resilience to the COVID-19 pandemic. BMJ Glob Health. 2021;6(7):e006794. 
[32] World Health Organization (WHO). 2019. Global Influenza Strategy 2019–2030; Geneva: World Health Organization (WHO). Available from: https://iris.who.int/bitstream/handle/10665/311184/9789241515320-eng.pdf
[33] Bai Y, Peng Z, Wei F, Jin Z, Wang J, Xu X, Zhang X, Xu J, Ren Z, Lu B, Wang Z, Xu J, Huang S. Study on the COVID-19 epidemic in Chinese mainland between November 2022 and January 2023, with prediction of its tendency. J Biosaf Biosecur. 2023;5(1):39-44. 
[34] Zheng L, Liu S, Lu F. Impact of National Omicron Outbreak at the end of 2022 on the future outlook of COVID-19 in China. Emerging Microbes & Infections, 2023;12(1):2191738. 
[35] Ge J. The COVID-19 pandemic in China: from dynamic zero-COVID to current policy. COVID-19-Pandemie in China: von der dynamischen Null-COVID- zur heutigen Politik. Herz. 2023;48(3):226-228. 
[36] Neill R, Hasan MZ, Das P, Venugopal V, Jain N, Arora D, Gupta S. Evidence of integrated health service delivery during COVID-19 in low and lower-middle-income countries: protocol for a scoping review. BMJ Open. 2021; 11(5): e042872. 
[37] Chen J, Feng H, Sun J, Jiang Y. Omicron wave during December 2022 - January 2023: access to pharmaceuticals and healthcare resources and impacts on health outcomes in Shenzhen, China. J Pharm Policy Pract. 2024;17(1): 2306867. 
[38] "Covid-19 in China: up to 70 per cent of Shanghai's population has now been infected, says leading city doctor". South China Morning Post. Available from: https: //web. archive. org/web/20230110172553/https: //www. scmp. com/news/china/science/article/3205455/covid-19-china-70-cent-shanghais-population-has-now-been-infected-says-leading-city-doctor
[39] "China's Zhejiang has 1 mln daily COVID cases, expected to double". Reuters. Available from: https: //www. reuters. com/world/china/chinas-national-health-commission-stop-publishing-daily-covid-figures-2022-12-25/
[40] "'Tragic Battle': On the Front Lines of China's Covid Crisis". New York Times. Available from: https://web.archive. org/web/20230114230656/https://www.nytimes.com/2022/12/27/world/asia/china-covid-hospital-crisis.html
[41] Huibert Jan Theodorus Zijderveld, Jori Pascal Kalkman, Emergent organizing: Origins and evolution of temporary crisis response organizations, International Journal of Project Management, 2023;41(5):1-10.
[42] Qian L, Sy LS, Hong V, Glenn SC, Ryan DS, Morrissette K, Jacobsen SJ, Xu S. Disparities in Outpatient and Telehealth Visits During the COVID-19 Pandemic in a Large Integrated Health Care Organization: Retrospective Cohort Study. J Med Internet Res. 2021;23(9):e29959. 
[43] He X, Sun X, Gong F, Li W, Lin J, Lin H, Hu G. A Large-Scale Screening Responding Sporadic Epidemic of COVID-19 in China by an Integrated Health-Care System. International Journal of Integrated Care, 2022; 22(1): 23, 1–12. 

Subscription
E-Mail Alert
Most popular papers
Call for Special Issue
Publication Ethics & OA Statement
Plagiarism Policy
Contact Us
Downloads: 4250
Visits: 239078

Sponsors, Associates, and Links

All published work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2016 - 2031 Clausius Scientific Press Inc. All Rights Reserved.