Table 1 Different types of IC in China

Contractual integration (CI)

CI seeks to build cooperative relationships among different institutions through formal contracts

Contract

Flexible: Healthcare institutions are flexible to cooperate in specific areas;

Trustful: Formal cooperative relationships could be formed between and among member institutions

Insufficient: Contracts can only cover certain areas of IC and is not sufficient to ensure the thorough and effective implementation of IC

Administrative integration (AI)

AI is featured with administrative characteristics that newly-built councils conduct united but limited management over financial, personnel, and property resources within the IC network

Management

Equal: Governments implement united but limited management over resources and therefore the distribution of resources could be more equal;

Powerful: AI is usually led by the officials of the government and therefore is powerful in implementing IC under the context of the Chinese political system

Incentive-lacking: Resource-rich public hospitals are unwilling to support primary healthcare institutions who need help; Private healthcare institutions lack incentives to participate due to their interest-seeking behaviour patterns

Insurance-driven integration (II)

II is mainly adopted by institutions covered by the same type of medical insurance

Insurance

Consistent: Member institutions are less likely to encounter barriers caused by different funding polices when implementing IC; People could be referred to different institutions under the same reimbursement policy

Geographically limited: It is difficult for institutions that are located in different administrative regions to cooperate

Virtual integration (VI)

VI is an emerging form of IC, with its emphasis on making full use of modern information technology

Technology

Accessible: It is beneficial for institutions located in remote rural areas to cooperate with healthcare institutions in developed areas;

Resource-saving: Since services are provided via technological devices, patients could save accommodation and transportation expenditures

Inconsistent: Healthcare institutions can only receive virtual support, which is limited in the long run; Patients cannot receive continuous healthcare services and they still need to visit hospitals in person after receiving online virtual diagnosis