Effect of Team Composition on Integrated Care Within Multidisciplinary Family Doctor Teams in China: Inter-Professional Collaboration as Mediator.

Abstract

Introduction: Integrated care (IC) is pivotal to China's primary healthcare reform under Healthy China 2030. Multidisciplinary family doctor teams (FDTs), with variable compositions, aim to deliver IC but face performance inconsistencies. While prior studies associate team composition with clinical outcomes, they neglect to elucidate the underlying mediating mechanisms. This study examines the association between FDT composition and IC, and whether inter-professional collaboration (IPC) may act as a mediator in this relationship.

Methods: This cross-sectional study surveyed 224 stratified-randomly sampled FDTs in Guangzhou in August 2023. Validated instruments were used to measure IPC and IC. We evaluated the potential mediating role of IPC using bias-corrected bootstrap procedures, and conducted a path analysis to explore the associations between IPC and IC.

Results: For standard teams compared with basic teams, the total effect on IC was not significant (B = 1.986, 95% CI: -0.719 to 4.691). The indirect effect via IPC was significant (B = 1.743, 95% CI: 0.490 to 3.128), while the direct effect was not significant (B = 0.243, 95% CI: -2.157 to 2.643). For advanced teams, the total effect was significant (B = 7.386, 95% CI: 4.316 to 10.456). Both the direct effect (B = 5.351, 95% CI: 2.624 to 8.077) and the indirect effect via IPC (B = 2.035, 95% CI: 0.548 to 3.492) were significant. Path analysis further examined the structural associations between IPC and the multifactorial components of IC.

Conclusion: For advanced teams, team composition was positively associated with IC, with IPC partially mediating this relationship. For standard teams, only the indirect effect via IPC was significant.