Blog
About

  • Record: found
  • Abstract: found
  • Article: found
Is Open Access

The health service capacity of primary health care in West China: different perspectives of physicians and their patients

Read this article at

Bookmark
      There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

      Abstract

      BackgroundMany countries, including China, have identified the primary health care system as a reform priority. The purpose of this study is to compare the perceived service capacity of primary care from the perspectives of physicians and their patients in Sichuan province of China.MethodsA cross-sectional survey was conducted through Quality and Costs of Primary Care (QUALICOPC) questionnaires. A representative sample of 319 primary care physicians and 641 patients in 48 primary healthcare settings were recruited to take part in the study.ResultsPhysicians perceived equity of care the best, while quality of care was rated the highest from the perspective of patients. They both regarded coordination as the weakest dimension of primary care service capacity.ConclusionsAlthough primary health care reform may have been effective in helping patients acquire better primary care services, our results suggest that coordination is still perceived to be problematic for both physicians and patients. Improving the coordination of care has to be one of the main goals in the future primary care reforms in China.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-3964-x) contains supplementary material, which is available to authorized users.

      Related collections

      Most cited references 38

      • Record: found
      • Abstract: found
      • Article: not found

      Early appraisal of China's huge and complex health-care reforms.

      China's 3 year, CN¥850 billion (US$125 billion) reform plan, launched in 2009, marked the first phase towards achieving comprehensive universal health coverage by 2020. The government's undertaking of systemic reform and its affirmation of its role in financing health care together with priorities for prevention, primary care, and redistribution of finance and human resources to poor regions are positive developments. Accomplishing nearly universal insurance coverage in such a short time is commendable. However, transformation of money and insurance coverage into cost-effective services is difficult when delivery of health care is hindered by waste, inefficiencies, poor quality of services, and scarcity and maldistribution of the qualified workforce. China must reform its incentive structures for providers, improve governance of public hospitals, and institute a stronger regulatory system, but these changes have been slowed by opposition from stakeholders and lack of implementation capacity. The pace of reform should be moderated to allow service providers to develop absorptive capacity. Independent, outcome-based monitoring and evaluation by a third-party are essential for mid-course correction of the plans and to make officials and providers accountable. Copyright © 2012 Elsevier Ltd. All rights reserved.
        Bookmark
        • Record: found
        • Abstract: found
        • Article: found
        Is Open Access

        The breadth of primary care: a systematic literature review of its core dimensions

        Background Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. Methods A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Results Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. Conclusions A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health.
          Bookmark
          • Record: found
          • Abstract: found
          • Article: not found

          Harnessing the privatisation of China's fragmented health-care delivery.

          Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail--population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals.
            Bookmark

            Author and article information

            Affiliations
            [1 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, Institute of Hospital Management, West China Hospital, , Sichuan University, ; Guo Xue Xiang 37, 610041 Chengdu, People’s Republic of China
            [2 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, West China School of Public Health, , Sichuan University, ; Chengdu, Sichuan China
            [3 ]ISNI 0000 0004 1770 1022, GRID grid.412901.f, Department of Respiratory Medicine, , West China Hospital of Sichuan University, ; Chengdu, Sichuan China
            Contributors
            tao_wenjuan@163.com
            zwqi123@yeah.net
            694963463@qq.com
            huazhenyang16@163.com
            huaxiwenjin@163.com
            weimi003@yahoo.com
            Journal
            BMC Health Serv Res
            BMC Health Serv Res
            BMC Health Services Research
            BioMed Central (London )
            1472-6963
            28 February 2019
            28 February 2019
            2019
            : 19
            30819168
            6396462
            3964
            10.1186/s12913-019-3964-x
            © The Author(s). 2019

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

            Funding
            Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
            Award ID: 71874115
            Award Recipient :
            Funded by: FundRef http://dx.doi.org/10.13039/501100004829, Department of Science and Technology of Sichuan Province;
            Award ID: 2018KZ0046
            Award Recipient :
            Categories
            Research Article
            Custom metadata
            © The Author(s) 2019

            Health & Social care

            health service capacity, primary care, qualicopc

            Comments

            Comment on this article