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Article: Health reforms in China: the public’s choices for first-contact care in urban areas

TitleHealth reforms in China: the public’s choices for first-contact care in urban areas
Authors
KeywordsChina
First-contact care
Health reforms
Primary care
Service users
Issue Date2017
PublisherOxford University Press. The Journal's web site is located at http://fampra.oxfordjournals.org/
Citation
Family Practice, 2017, v. 34 n. 2, p. 194-200 How to Cite?
AbstractPurpose. To examine the public's views towards their choice of first-contact care and its associated factors in urban China. Methods. A mixed-method study was adopted using individual interviews, focus group interviews and a cross-sectional survey. The study was conducted among the general public between September 2014 and September 2015 in Zhejiang province, China. Results. Six focus groups and 13 individual interviews were conducted. The questionnaire was completed by 1248 respondents with a response rate of 83%. Survey results showed that 70% of the respondents preferred hospital-based services for first-contact care, it is especially the case with paediatric patients (83.3%). The qualitative data revealed that a major cause was the public distrust in the competence of primary care practitioners with lower educational qualifications. In the decision-making process, compared to cost factors like medical expenses and waiting times, participants attached greater emphasis on organizational characteristics. Respondents who rated sophisticated medical equipment, reputation of the facility, average education of doctors as important were significantly more inclined to choose hospital services. Respective adjusted odds ratios (AOR) were 2.14 (P < 0.001), 1.83 (P < 0.001) and 1.40 (P = 0.043) for their own conditions and 2.19 (P = 0.004), 1.94 (P = 0.002) and 1.86 (P = 0.003) for their children's conditions. Availability of medications and perceived severity of illness were also significantly associated with their choice of hospital services for their children. Conclusion. The public's preference for hospital-based services for first-contact care places a huge obstacle to promoting community-based primary care. Addressing the public's concerns about the primary care practitioners' competence is worth more efforts. © The Author 2017. Published by Oxford University Press. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/238667
ISSN
2017 Impact Factor: 1.675
2015 SCImago Journal Rankings: 1.048
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWu, D-
dc.contributor.authorLam, TP-
dc.contributor.authorLam, KF-
dc.contributor.authorZhou, XD-
dc.contributor.authorSun, KS-
dc.date.accessioned2017-02-20T01:24:31Z-
dc.date.available2017-02-20T01:24:31Z-
dc.date.issued2017-
dc.identifier.citationFamily Practice, 2017, v. 34 n. 2, p. 194-200-
dc.identifier.issn0263-2136-
dc.identifier.urihttp://hdl.handle.net/10722/238667-
dc.description.abstractPurpose. To examine the public's views towards their choice of first-contact care and its associated factors in urban China. Methods. A mixed-method study was adopted using individual interviews, focus group interviews and a cross-sectional survey. The study was conducted among the general public between September 2014 and September 2015 in Zhejiang province, China. Results. Six focus groups and 13 individual interviews were conducted. The questionnaire was completed by 1248 respondents with a response rate of 83%. Survey results showed that 70% of the respondents preferred hospital-based services for first-contact care, it is especially the case with paediatric patients (83.3%). The qualitative data revealed that a major cause was the public distrust in the competence of primary care practitioners with lower educational qualifications. In the decision-making process, compared to cost factors like medical expenses and waiting times, participants attached greater emphasis on organizational characteristics. Respondents who rated sophisticated medical equipment, reputation of the facility, average education of doctors as important were significantly more inclined to choose hospital services. Respective adjusted odds ratios (AOR) were 2.14 (P < 0.001), 1.83 (P < 0.001) and 1.40 (P = 0.043) for their own conditions and 2.19 (P = 0.004), 1.94 (P = 0.002) and 1.86 (P = 0.003) for their children's conditions. Availability of medications and perceived severity of illness were also significantly associated with their choice of hospital services for their children. Conclusion. The public's preference for hospital-based services for first-contact care places a huge obstacle to promoting community-based primary care. Addressing the public's concerns about the primary care practitioners' competence is worth more efforts. © The Author 2017. Published by Oxford University Press. All rights reserved.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://fampra.oxfordjournals.org/-
dc.relation.ispartofFamily Practice-
dc.rightsPre-print: Journal Title] ©: [year] [owner as specified on the article] Published by Oxford University Press [on behalf of xxxxxx]. All rights reserved. Pre-print (Once an article is published, preprint notice should be amended to): This is an electronic version of an article published in [include the complete citation information for the final version of the Article as published in the print edition of the Journal.] Post-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here].-
dc.subjectChina-
dc.subjectFirst-contact care-
dc.subjectHealth reforms-
dc.subjectPrimary care-
dc.subjectService users-
dc.titleHealth reforms in China: the public’s choices for first-contact care in urban areas-
dc.typeArticle-
dc.identifier.emailLam, TP: tplam@hku.hk-
dc.identifier.emailLam, KF: hrntlkf@hkucc.hku.hk-
dc.identifier.authorityLam, TP=rp00386-
dc.identifier.authorityLam, KF=rp00718-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/fampra/cmw133-
dc.identifier.pmid28122845-
dc.identifier.scopuseid_2-s2.0-85018954237-
dc.identifier.hkuros271251-
dc.identifier.volume34-
dc.identifier.issue2-
dc.identifier.spage194-
dc.identifier.epage200-
dc.identifier.isiWOS:000397996100011-
dc.publisher.placeUnited Kingdom-

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