# Key Motivators and Framework for Integrated Care by Family Physician Team Members in Urban China

## TL;DR

This study identifies motivators for family physicians in China to improve integrated care through a framework based on government, institutions, teams, and residents.

## Contribution

A novel mixed-methods framework to analyze motivators for integrated care delivery by family physician teams in urban China.

## Key findings

- 64 first-order concepts were grouped into 15 themes across four dimensions: government, institutions, teams, and residents.
- Government-level motivators like IT infrastructure and resource allocation were key drivers of integrated care.
- Resident-level factors such as trust were found to be reactive rather than proactive in influencing care integration.

## Abstract

This study aimed to develop an analytical framework to investigate the key motivators influencing family physician team members (FPTMs) in delivering integrated care at the primary healthcare (PHC) level within urban China. The objective was to identify critical factors based on cause and effect relationships, with the ultimate aim of enhancing the integration of primary care and public health services.

A mixed-methods design was implemented, integrating thematic analysis and the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method. Data were gathered from semi-structured interviews with 24 participants, comprising FPTMs and administrators from Wuhan, Shenzhen, and Shanghai, collected between January and July 2022. The thematic analysis facilitated the construction of an initial framework of motivators, while the DEMATEL method was employed to examine and map the interdependent relationships among these motivators.

The analysis distilled 64 first-order concepts into 15 second-order themes, which were then categorized into four broader dimensions: Government agencies, PHC institutions, family physician teams (FPTs), and residents. Motivators at the government level, such as resource allocation and the development of information technology (IT) infrastructure, were identified as proactive forces driving change. In contrast, resident-level factors, including trust and adherence, were more reactive, shaped by external conditions and responsive rather than initiators of change.

The findings emphasize the pivotal role of government leadership in fostering the adoption of integrated care. Key strategies include enhancing interdisciplinary team collaboration, optimizing performance evaluations, and refining incentive structures to boost FPTMs’ motivation. Equally important is the need to encourage residents to engage in proactive health management, promoting a collaborative care model that integrates both FPTMs and the communities they serve.