Construction of lymphedema integrated service system based on rainbow model

LIAN Xiaohan; SONG Qiuxiang; ZHAO Xiaoyan; GAO Jieqiong; FENG Xiongli; LI Shupei; ZHANG Xuan

doi:10.12102/j.issn.1009-6493.2025.23.006

Abstract：Objective:This study aimed to systematically evaluate the current status of lymphedema services across 46 medical institutions in Shanxi province,and to lay some groundwork for constructing an integrated service system for lymphedema patients.Methods:A self-design questionnaire was adopted to investigate the medical resources and services available for lymphedema in Shanxi province.The identified challenges were analyzed through the lens of the rainbow model,encompassing macro,meso,micro,and supporting elements.The lymphedema integrated service system was formed.Results:Although the construction of regional lymphedema service system has made some progress,several significant barriers persist,including the disparities in distribution of medical resources,insufficient institutional and policy support for an integrated lymphedema service system,unclear functional roles and responsibilities among medical institutions,and the existence of unique lymphedema service pricing items that were not covered by health insurance.The formed lymphedema integrated service system included four levels:macro,meso,micro,and supporting elements.Conclusions:It is recommended that,at the macro level,health administrative departments assume a regulatory role to promote regional integration and optimize resource allocation,implement supportive policies to clarify the functional roles of medical institutions at various levels,ensure financial subsidies to medical institutions,collaborate with medical insurance departments to dynamically adjust service pricing,and improve payment policies and patients' medical security treatment;enhance subsidies for these institutions,collaborate with medical insurance departments to dynamically adjust service pricing,and enhance patients' medical security and payment policies.At the meso level,efforts should focus on establishing a specialist medical consortium,optimizing referral mechanisms,strengthening multidisciplinary collaboration and scientific research innovation,enhancing talent development,and facilitating resource allocation.At the micro level,it is essential to develop a closed-loop management system,to strenthen community health education,and to explore innovative home service model for lymphedema therapists.At the level of supporting elements,the application of information technology is crucial for creating an information-sharing platform,improving service supervision systems,establishing appropriate salary and performance evaluation systems for lymphedema therapists and multidisciplinary teams,enhancing public awareness and guidance,and developing effective operational procedures for the establishment of an integrated lymphedema service system.