Research on Implementation Mechanism of Treatment-prevention Integration Under the Background of Constructing Integrated Service System

Abstract: Background　The key task in China's medical and health field during the "14th Five-Year Plan" period is to realize treatment-prevention integration and innovate the mechanism of treatment-prevention integration. Objective　This paper analyzes the implementation mechanism of treatment-prevention integration under the background of integrated service system construction，and provides reference for exploring the path of medical and prevention integration adapting to the strategy of “Healthy China”. Methods　Taking 2018 as the time node，relevant literature was searched on CNKI and Wanfang data knowledge service platform with keywords of "treatment-prevention integration"，"medical and prevention coordination"，"combination of prevention and treatment" and literatures on case policies，measures and implementation effects of integrated service systems such as medical alliance. Finally，18 literatures and 15 cases were selected. Based on the rainbow model，system integration，organizational integration，professional integration，service integration，functional integration and normative integration were determined as condition variables from macro，meso and micro levels and supporting factors，and the effect of treatment-prevention integration was determined as result variable. QCA was adopted to explore the implementation mechanism of medical and preventive integration under the background of integrated service system construction. Results　There were four configuration paths that could effectively improve the effect of treatment-prevention integration，and the four paths were in line with the multi-layer integrated path and the medium-micro integrated path respectively. The following results were obtained：（1）It was more effective to carry out treatment-prevention integration relying on the integrated service system，and there are multiple paths that can effectively improve the effect of treatment-prevention integration under the integrated service system；（2）Service integration plays a fundamental role in improving the effect of medical and preventive integration；（3）The setting of relevant policy indicators for improving the system integration，professional integration and functional integration of treatment-prevention integration is not perfect. Conclusion　（1）Relying on the construction of integrated service system to promote the improvement of treatment-prevention integration effect；（2）Give full play to the basic guarantee role of service integration；（3）Make reference to the successful experience of multi-level integration cases，set policy indicators at macro，meso and micro levels in a balanced manner，and improve the integration of system integration，professional integration and supporting elements.