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Combining Resource, Structure and Institutional Environment: A Configurational Approach to the Mode Selection of the Integrated Healthcare in County

Author

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  • Li Zhu

    (School of Public Administration, Central South University, Changsha 410083, China)

  • Zixuan Peng

    (School of Public Health, University of Toronto, Toronto, ON M2J 4A6, Canada)

  • Lihang Liu

    (School of Public Administration, Central South University, Changsha 410083, China)

  • Shuang Ling

    (School of Public Administration, Central South University, Changsha 410083, China)

Abstract

Integrated healthcare has received considerable attention and has developed into the highly important health policy known as Integrated Healthcare in County (IHC) against the background of the Grading Diagnosis and Treatment System (GDTS) in rural China. However, the causal conditions under which different integrated health-care modes might be selected are poorly understood, particularly in the context of China’s authoritarian regime. This study aims to identify these causal conditions, and how they shape the mode selection mechanism for Integrated Healthcare in County (IHC). A theoretical framework consisting of resource heterogeneity, governance structure, and institutional normalization was proposed, and a sample of fifteen IHCs was selected, with data for each IHC being collected from news reports, work reports, government documents and field research for Fuzzy-sets Qualitative Comparative Analysis (fsQCA). This study firstly pointed out that strong governmental control and centralization are necessary conditions for the administration-oriented organization mode (MOA). Additionally, this research found three critical configured paths in the selection of organizational modes. Specifically, we found that the combination of low resource heterogeneity, weak governmental control, centralization, and normalization was sufficient to explain the selection path of the insurance-driven organization mode (MOI); the combination of low resource heterogeneity, strong governmental control, centralization, and normalization was sufficient for selecting MOA; and the combination of weak governmental control, weak centralization, and weak normalization was sufficient for selecting the contractual organization mode (MOC). Our study highlighted the necessity and feasibility of constructing different IHC modes separately and promoting their development gradually, as a result of the complex relationships among the causal conditions described above, thus helping to optimize the distribution of health resources and integrate the healthcare system.

Suggested Citation

  • Li Zhu & Zixuan Peng & Lihang Liu & Shuang Ling, 2019. "Combining Resource, Structure and Institutional Environment: A Configurational Approach to the Mode Selection of the Integrated Healthcare in County," IJERPH, MDPI, vol. 16(16), pages 1-18, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:16:p:2975-:d:258837
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    References listed on IDEAS

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    3. Ebenezer Owusu-Addo & Ruth Cross, 2014. "The impact of conditional cash transfers on child health in low- and middle-income countries: a systematic review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(4), pages 609-618, August.
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