Continuity of health care: measurement and application in two rural counties of Guangxi Province, China

Qianchen Wei; Beibei Yuan; Jin Xu; Ping He; Hanyi Xu; Qingyue Meng

doi:10.1186/s12913-023-09916-4

Continuity of health care: measurement and application in two rural counties of Guangxi Province, China

BMC Health Serv Res. 2023 Aug 29;23(1):917. doi: 10.1186/s12913-023-09916-4.

Authors

Qianchen Wei^{1

2}, Beibei Yuan², Jin Xu², Ping He², Hanyi Xu², Qingyue Meng³

Affiliations

¹ Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
² China Center for Health Development Studies, Peking University Health Science Center, Beijing, China.
³ China Center for Health Development Studies, Peking University Health Science Center, Beijing, China. qmeng@bjmu.edu.cn.

Abstract

Background: Continuity of care (COC) is highly regarded in health promotion and health system strengthening. However, there is a lack of multidimensional quantitative assessment of continuity, making it challenging to evaluate and compare. Our objective was to create a novel measurement for COC and apply it in two rural counties in China to assess its validity and feasibility in evaluating health system reform.

Method: This study conducted a scoping literature review on COC, examining existing frameworks and indicators. Following an online expert poll, a composite indicator was developed using the analytical hierarchy process (AHP). The measurement tool was then applied to assess the current state of COC in two rural counties in China. In addition to descriptive analysis, demographic and economic characteristics were analyzed for their association with COC scores using t-tests and multiple linear regression models.

Results: The final COC measurement encompasses three dimensions, six sub-dimensions, and ten individual indicators, which integrated and improved the current frameworks and indicators. Relational continuity, informational continuity, and management continuity were identified as the primary dimensions of COC measurement. The COC score is 0.49 in County A and 0.41 in County B, with information continuity being the highest-scoring dimension. Notably, the disparity in continuity scores is most pronounced among individuals with varying attitudes towards health, demonstrating a positive correlation.

Conclusion: The construction of the composite indicator in this study offers a scientific and effective metric for comprehensively measuring continuity of care. The empirical data analysis conducted in Western China serves as an illustrative application of the indicator, demonstrating its efficiency. The results obtained from this analysis provide a solid foundation and valuable reference for strengthening the health system.

Keywords: AHP; Composite Indicator; Continuity of care; Rural County.

Publication types

Review

MeSH terms

Analytic Hierarchy Process*
China
Continuity of Patient Care*
Data Analysis
Delivery of Health Care
Humans