Integrated PHC System in Rural China — A Case Study of Yangzhou, Jiangsu Province

Yangzhou City has taken comprehensive measures with the main goal of improving the capacity of rural primary healthcare in response to the improvements of the health and health service demands of rural residents, including establishing regional healthcare centers in rural areas, constructing distinctive departments in township health centers (THCs), strengthening the construction of a primary health workforce, and increasing financial investment in rural health. All these measures have achieved good outcomes.To ensure the implementation and effectiveness of these measures, the municipal government has introduced corresponding policies to encourage and guide hospitals at the city and county levels to vertically integrate with primary health institutions, based on the platforms of characteristic departments, medical specialist studios, and hospital–THC joint wards to achieve health service collaboration.It has adopted multiple supportive policies to promote the establishment of a people-centered integrated primary healthcare (PCIPHC) system. The policies include enhancing information system construction to facilitate healthcare utilization, increasing health insurance reimbursement rates for primary health services to guide the first consultation at the primary level, and strengthening national basic public health services such as health management for key populations to ensure the entire population’s health.The city is still facing crucial challenges in establishing a PCIPHC system and a relevant model. A good mechanism will be vital to coordinate health institutions. There still exist some risks in the supporting measures of a PCIPHC system. Health insurance should play a leading role in rational healthcare delivery. The Yangzhou municipal government is utilizing the National Public Hospital Reform and the High-Quality Development Demonstration Project to explore more effective solutions for the construction and management of a PCIPHC system.