An early assessment of the County Medical Community reform in China: a case study of Zhejiang province

Started in Anhui province, later introduced into Shanxi and Zhejiang province and now extensively piloted nationwide, the County Medical Community is China's version of an integrated health-care delivery system which aims at strengthening the primary health-care system and take full advantage of health-care resources. In this early assessment, we analyzed the content of the County Medical Community Reform in detail in order to understand its operation mechanism, and conducted a case study of Zhejiang. We used the WHO Health Systems Performance Assessment Framework to analyze 11 pilot counties which implemented the County Medical Community Reform in 2017 in Zhejiang province together with a 11 counties that did not launch the County Medical Community Reform for comparison. We found that the implementation of the County Medical Community Reform had several noticeable results in the fields of stewardship, financing and fair financial contribution, creating resources, delivering services, and health-care. Additionally, during the outbreak of Coronavirus disease (COVID-19), we found County Medical Community exert positive influence on the disease diagnosis and treatment in the primary health-care system in Zhejiang province. Finally, we summarized the lessons learned and offered several recommendations regarding the future development of the County Medical Community. Furthermore, we sought to shed light on methods for optimizingthe primary health-care system in China.