A Quantitative Research on Effectiveness of China's Community-dwelling Integrated Medical and Elderly Care Policy from the Perspective of Health Service Continuity

Background Providing continuous health services is a key task in community-dwelling integrated medical and elderly care, policy design plays a crucial role in the construction of continuous health service system, but previous research is limited in analyzing the continuous health service policy of community-dwelling integrated medical and elderly care in China. Objective To analyze the characteristics and shortcomings of policies of community-dwelling integrated medical and elderly care in China, and provide policy recommendations for improving the continuous health service system of community-dwelling integrated medical and elderly care. Methods In May 2024, search policy documents on the website "www.pkulaw.com", using the title keywords "integrated medical and elderly care" "elderly care service" "elder" "ageing", the leading department of introduction is national level (Central Committee of the Communist Party of China, State Council), or competent departments of health service (National Health Commission, National Healthcare Security Administration, National Administration of Traditional Chinese Medicine, or National Disease Control and Prevention Administration), introduced from January 2000 to May 2024, and related to continuous health service of community-dwelling integrated medical and elderly care, select as samples (n=41). Based on the indicators system of continuous health services, policy tool types, and policy effectiveness scores, establish a three-dimensional analysis framework to quantitatively analyze the policies. Results The proportion of policy effectiveness scores for the indicators of relationship continuity, information continuity, and management continuity accounted for 8.62% (264/3 063), 10.61% (325/3 063), and 80.77% (2 474/3 063), respectively. The proportion of policy effectiveness scores and importance weights in the tertiary indicators were severely mismatched, with a Pearson correlation coefficient of only -0.10 (P>0.05). The effectiveness scores of market-oriented tools, business management techniques, and socialization methods account for 22.62% (693/3 063), 67.29% (2 061/3 063), and 10.09% (309/3 063), respectively. The overall average score for policy effectiveness is 12.20, while the average scores for policy effectiveness for relationship continuity, information continuity, and management continuity are 13.89, 16.25, and 11.67, respectively. The average scores for the effectiveness of market-oriented tools, business management techniques, and socialization methods policies are 16.90, 11.45, and 10.30, respectively. The average effectiveness scores of policy measures and targets are 3.25 and 2.80, respectively, with a difference of 16.07%. The overall average effectiveness score of policy measures and targets is only 3.03, close to 3.00 which is the critical value of specificity. Conclusion There is room for improvement in the effectiveness distribution, tool selection, and specificity of China's continuous health service policy of community-dwelling integrated medical and elderly care. We suggest that the effectiveness of policy should scientifically cover the continuity indicators of health service and enhance the sense of gain of elderly people in home-based communities. Increase the use of market-oriented tools and strengthen economic stimulation for market entities. Balance the effectiveness of policy measures and targets, and improve the specificity of policy.