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Article: Bridging The Gaps Between Patients And Primary Care In China: A Nationwide Representative Survey

TitleBridging The Gaps Between Patients And Primary Care In China: A Nationwide Representative Survey
Authors
KeywordsChina
Delivery of care
Health personnel
Patient acceptance of health care
Primary care
Quality of care
Structure of care
Issue Date2017
PublisherAnnals of Family Medicine, Inc. The Journal's web site is located at http://www.annfammed.org/
Citation
Annals of Family Medicine, 2017, v. 15 n. 3, p. 237-245 How to Cite?
AbstractPURPOSE China introduced a national policy of developing primary care in 2009, establishing 8,669 community health centers (CHCs) by 2014 that employed more than 300,000 staff. These facilities have been underused, however, because of public mistrust of physicians and overreliance on specialist care. METHODS We selected a stratified random sample of CHCs throughout China based on geographic distribution and urban-suburban ratios between September and December 2015. Two questionnaires, 1 for lead clinicians and 1 for primary care practitioners (PCPs), asked about the demographics of the clinic and its clinical and educational activities. Responses were obtained from 158 lead clinicians in CHCs and 3,580 PCPs (response rates of 84% and 86%, respectively). RESULTS CHCs employed a median of 8 physicians and 13 nurses, but only one-half of physicians were registered as PCPs, and few nurses had training specifically for primary care. Although virtually all clinics were equipped with stethoscopes (98%) and sphygmomanometers (97%), only 43% had ophthalmoscopes and 64% had facilities for gynecologic examination. Clinical care was selectively skewed toward certain chronic diseases. Physicians saw a median of 12.5 patients per day. Multivariate analysis showed that more patients were seen daily by physicians in CHCs organized by private hospitals and those having pharmacists and nurses. CONCLUSIONS Our survey confirms China’s success in establishing a large, mostly young primary care workforce and providing ongoing professional training. Facilities are basic, however, with few clinics providing the comprehensive primary care required for a wide range of common physical and mental conditions. Use of CHCs by patients remains low.
Persistent Identifierhttp://hdl.handle.net/10722/247499
ISSN
2023 Impact Factor: 4.4
2023 SCImago Journal Rankings: 0.897
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, WCW-
dc.contributor.authorJiang, SF-
dc.contributor.authorOng, JJ-
dc.contributor.authorPeng, MH-
dc.contributor.authorWan, YF-
dc.contributor.authorZhu, SZ-
dc.contributor.authorLam, CLK-
dc.contributor.authorKidd, MR-
dc.contributor.authorRoland, M-
dc.date.accessioned2017-10-18T08:28:14Z-
dc.date.available2017-10-18T08:28:14Z-
dc.date.issued2017-
dc.identifier.citationAnnals of Family Medicine, 2017, v. 15 n. 3, p. 237-245-
dc.identifier.issn1544-1709-
dc.identifier.urihttp://hdl.handle.net/10722/247499-
dc.description.abstractPURPOSE China introduced a national policy of developing primary care in 2009, establishing 8,669 community health centers (CHCs) by 2014 that employed more than 300,000 staff. These facilities have been underused, however, because of public mistrust of physicians and overreliance on specialist care. METHODS We selected a stratified random sample of CHCs throughout China based on geographic distribution and urban-suburban ratios between September and December 2015. Two questionnaires, 1 for lead clinicians and 1 for primary care practitioners (PCPs), asked about the demographics of the clinic and its clinical and educational activities. Responses were obtained from 158 lead clinicians in CHCs and 3,580 PCPs (response rates of 84% and 86%, respectively). RESULTS CHCs employed a median of 8 physicians and 13 nurses, but only one-half of physicians were registered as PCPs, and few nurses had training specifically for primary care. Although virtually all clinics were equipped with stethoscopes (98%) and sphygmomanometers (97%), only 43% had ophthalmoscopes and 64% had facilities for gynecologic examination. Clinical care was selectively skewed toward certain chronic diseases. Physicians saw a median of 12.5 patients per day. Multivariate analysis showed that more patients were seen daily by physicians in CHCs organized by private hospitals and those having pharmacists and nurses. CONCLUSIONS Our survey confirms China’s success in establishing a large, mostly young primary care workforce and providing ongoing professional training. Facilities are basic, however, with few clinics providing the comprehensive primary care required for a wide range of common physical and mental conditions. Use of CHCs by patients remains low.-
dc.languageeng-
dc.publisherAnnals of Family Medicine, Inc. The Journal's web site is located at http://www.annfammed.org/-
dc.relation.ispartofAnnals of Family Medicine-
dc.rightsWritten permission must be gained from publisher-
dc.subjectChina-
dc.subjectDelivery of care-
dc.subjectHealth personnel-
dc.subjectPatient acceptance of health care-
dc.subjectPrimary care-
dc.subjectQuality of care-
dc.subjectStructure of care-
dc.titleBridging The Gaps Between Patients And Primary Care In China: A Nationwide Representative Survey-
dc.typeArticle-
dc.identifier.emailWong, WCW: wongwcw@hku.hk-
dc.identifier.emailWan, YF: yfwan@hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityWong, WCW=rp01457-
dc.identifier.authorityWan, YF=rp02518-
dc.identifier.authorityLam, CLK=rp00350-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1370/afm.2034-
dc.identifier.pmid28483889-
dc.identifier.pmcidPMC5422085-
dc.identifier.scopuseid_2-s2.0-85019076549-
dc.identifier.hkuros281159-
dc.identifier.volume15-
dc.identifier.issue3-
dc.identifier.spage237-
dc.identifier.epage245-
dc.identifier.isiWOS:000402477900008-
dc.publisher.placeUnited States-
dc.identifier.issnl1544-1709-

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