Analysis of the integration reform of the UK health services in the context of “purchaser-provider split” and its enlightenment to China

Corresponding author: XU Jin, xujin@hsc.pku.edu.cn

DOI: 10.12201/bmr.202004.00029

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  Abstract: The people-centered integrated care is an important direction on the international development of health system. The comprehensive performance of the British health system stays ahead of other developed countries, and the British “purchaser-provider split” framework in which the government is responsible for financing and organizing is similar to its in China. For the above reasons and based on the information gained by the literature research and field investigation, this study analyzed the logic and practical progress of the people-centered integrated care system in the UK in recent years, and discussed the enlightenment to China. This study found that the integration reform in the UK is mainly represented in three aspects: At the regional level, the reform promotes integrated planning of various institutions within the health sector and cross-sectoral services, and the transformation fund, performance assessment, integrated budget allocation and decision-making mechanism are supplemented; At the local level, the financing integration of public health and medical services promotes the coordination of services around the local population and addresses the problems at the population level. At the community level, the reform addresses the determinants of health at the individual and community levels comprehensively by re-organizing the practice patterns of general practitioners and combining community services on the basis of the primary care network. Based on the experience of the UK, this study proposes following three enlightenments to China: The integration reform involves multiple levels and the respective rights and responsibilities should be clarified; The integrated decision-making and accountability, and coordinated resource allocation are the key to promoting integration; The development of community-level healthcare needs to be organized on the basis of professionalization.

  Key words: Integrated health care; People-centered; Purchaser-provider split; Internal market

  Submit time: 27 October 2020

  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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