Presentation (CTI)

OBJECTIVES: Community resilience is critical for mitigating infectious disease shocks, sustaining essential services, and protecting population health. Communities are the frontline settings where transmission risks are experienced and where public health measures are ultimately implemented. Although integrated healthcare delivery has been widely promoted to improve service coordination and strengthen primary care systems, its contribution to community resilience during infectious disease crisis remains insufficiently understood. This study examined the association between integrated healthcare delivery and community resilience during seasonal influenza in a Chinese megacity with a population of over 10 million.
METHODS: This community-level observational study linked medical consortium (MC) performance scores with Weibo data from the 2023 influenza season. We collected 1,022,284 geolocated posts from 123 communities. Community resilience was captured across absorptive, adaptive, and recovery-learning capacity via eight indicators from post content, sentiment, and interactions. A fine-tuned BERT-base-Chinese model classified posts and sentiment. OLS regressions estimated associations; the 2024-25 season was used for robustness.
RESULTS: Higher MC performance was positively linked to overall community resilience during the influenza shock. For every one-point gain in the MC score, the overall resilience score rose by 0.4 percentage points (95% CI: 0.003-0.006, p<0.001). Disaggregated analyses showed comparable gains at the sub-dimensional level: 0.2 points for adaptive capacity (95% CI: 0.001-0.003, p<0.001) and 0.2 points for recovery-learning capacity (95% CI: 0.001-0.003, p=0.001). Absorptive capacity was non-significant.
CONCLUSIONS: Integrated healthcare delivery showed significant associations with the adaptive and recovery-learning dimensions of community resilience, while its link to absorptive capacity was not detected. This suggests that integrated healthcare primarily support dynamic coordination and collective learning through service connectivity and organisational linkages, whereas initial absorption may depend more on structural conditions and the community resource base.