By John Butcher
Duke Kunshan University has released two policy-oriented research reports aimed at improving global healthcare policies.
Produced by the Duke Kunshan Research Hub of the Asia-Pacific Observatory on Health Systems and Policy, which is hosted by the World Health Organization, the papers cover improving healthcare systems through greater integration of services and using the internet and other technologies to enhance health services and information delivery.
“Across both papers researchers have looked in detail at health service policies and implementation, and compared outcomes across different countries. These are comprehensive studies that contribute to an important discussion about how to best deliver health services,” said Shenglan Tang, deputy director of Duke Global Health Institute and co-director of the Global Health Research Center (GHRC) at Duke Kunshan University.
Integrated care for chronic diseases in Asia Pacific countries, edited by Chang Liu, managing director for Singapore and mainland China at ACCESS Health International, and Tang, who is Mary and James Semans Professor of Medicine and Global Health, addresses tackling emerging health challenges posed by ageing populations across Asia Pacific through more integrated healthcare systems.
Shenglan Tang, co-director of the Global Health Research Center at Duke Kunshan University
With a quarter of the Asia Pacific region population due to be 60 or older by 2050, according to WHO predictions, long term chronic disease will become more common, leading to rising healthcare costs, hospital bed shortages and imbalanced resources between acute and primary care.
The study looked at integrated care across the Asia Pacific region, examining systems in China, Singapore, the Philippines, India, Vietnam and Fiji, through a combination of desk-based research, interviews and deep-dive case studies. Overall, it examined the effectiveness of 87 integrated care programmes for chronic diseases in all countries, with the largest numbers in China (44) and Singapore (21).
The paper recommends tackling these issues by shifting focus away from hospital care to “ensuring care coordination and continuity of care across primary, hospital and post-acute settings.”
It identifies several factors that help with the development of such a system including: strong leadership combined with local flexibility, financial and non-financial incentives for both healthcare providers and users, training for community care workers, collecting accurate health information and ongoing performance assessments for integrated care programmes to measure their effectiveness.
The other research paper, Use of E-Health Programmes to Deliver Urban Primary Healthcare Services for Noncommunicable Diseases in Middle-Income Countries, was authored by a group of researchers including three from DKU: Lijing Yan, professor for global health, Shangzhi Xiong, a 2018-class global health master student and research analyst at GHRC, and Hongsheng Lu, a 2020-class global health master student. They worked on it with Lia Palileo-Villanueva, a professor at the University of the Philippines, Hao Li, who teaches at Wuhan University, Abha Shrestha, who works at Kathmandu University School of Medical Sciences and Peter Otieno, a researcher at the African Population and Health Research Center.
Research project fieldwork being carried out in Nepal
The research team reviewed scientific and grey literature, and conducted in-depth interviews in China, Nepal, the Philippines and Kenya, to examine the role of information and communication technologies in the prevention and control of noncommunicable diseases, which often require long-term prevention-orientated healthcare.
Healthcare providers saw multiple benefits to e-health measures, including reduced workloads, higher efficiency, and more convenient data storage and communications, according to the study. Patients described greater satisfaction with services, better continuity of care and higher quality of care.
The paper recommends a range of measures that could promote e-health system development including: policy and financial support, a standardization of systems and devices, improved Internet and power supplies, training, user-centred design of e-health systems, and financial and other incentives to adopting new technology.
“Changing demographics and health challenges require new approaches to healthcare that utilize modern technology and ideas, if we are to tackle them efficiently,” said DKU chancellor Youmei Feng.
“DKU is committed to this kind of research that has the potential to have a positive impact on the world around us.”
