An evaluation of the policy on community health organizations in China: Will the priority of new healthcare reform in China be a success?

Wang, Hufeng; Gusmano, Michael K.; Cao, Qing

doi:10.1016/j.healthpol.2010.07.003

Cited by 112 publications

(93 citation statements)

References 15 publications

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“…Furthermore, all CHCs will eventually be financed by the government. 9 As of 2009, 234 total government-owned CHCs have been established in Hubei Province. For this analysis, CHCs were divided into 3 groups: 95 in capital urban districts, 73 in noncapital urban districts, and 66 in small urban districts.…”

Section: Sampling Methodsmentioning

confidence: 99%

“…4,5,7,8 The central government plans to set up CHCs responsible for delivery of public health services and essential medical care services. 9 The district governments invest the provision of public health services. In general, government-owned CHCs, accounting for 77% of all CHCs, obtain more subsidies than enterprise-owned and private CHCs.…”

Section: Introductionmentioning

confidence: 99%

“…10 As of 2008, the community health service system has been built. 9 Additionally, 72% of the urban population has been covered by health insurance. 13 However, TCM resources of CHCs among eastern, central, and western China show unequal distribution, and the utilization of outpatient services provided by CHCs has not improved as much as expected.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated With Traditional Chinese Medicine Utilization Among Urban Community Health Centers in Hubei Province of China

Cai

Mao

et al. 2013

Asia Pac J Public Health

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This study aims to examine resources and utilization of traditional Chinese medicine (TCM) and factors influencing TCM utilization in urban community health centers (CHCs) in Hubei Province of China. A cross-sectional survey including 234 government-owned CHCs was conducted in 2009. One-way analysis of variance analysis and a Poisson regression model were used to examine distribution of TCM resources and factors influencing TCM utilization. This study found unequal distribution of TCM resources among districts. TCM outpatient visits were positively associated with higher economic development districts, lower initial capital investment of the CHCs, health services covered by health insurance, higher qualification of TCM physicians, provision of TCM health records and rehabilitation, and greater availability of herbal medicine. To achieve equal access to TCM services, policy makers should consider the socioeconomic differences and income groups, provide training for TCM physicians, build pathway to recruit senior TCM physicians, and cover more TCM therapies by health insurance.

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Section: Sampling Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Associated With Traditional Chinese Medicine Utilization Among Urban Community Health Centers in Hubei Province of China

Cai

Mao

et al. 2013

Asia Pac J Public Health

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“…Regarding associated factors, a survey conducted before the launch of health reforms found that 91% of respondents showed a lack of trust in primary care practitioners (PCPs). Some health policy researchers also regarded patients' low trust in community-based care as a barrier to their utilization of primary care (8)(9)(10). Despite these studies, an in-depth understanding of service users' health care utilization preferences is still lacking.…”

Section: Introductionmentioning

confidence: 99%

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

Lam

et al. 2017

FAMPRJ

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Purpose. 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.

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“…The barefoot doctor model was gradually dismantled when a shift in funding from primary health care to hospital-based care occurred; this led to the proliferation of specialized care in hospitals. 9 To ensure access to basic medical services for all, fees for services have been set lower than costs at all government-run facilities. 10 The government subsidized only 10% of hospital revenue 11 but allowed a markup of 15% on drugs and high-tech tests so facilities could survive.…”

mentioning

confidence: 99%

Underuse of Primary Care in China: The Scale, Causes, and Solutions

Lam

2016

The Journal of the American Board of Family Medicine

110

117

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Strengthening the primary care system and promoting utilization of primary care are the major targets of China's ambitious health reforms to meet its people's escalating health care needs. However, the changing trend of primary care utilization 4 years before and after 2009, when the health reforms started, is against the government's stated goal. The percentage of outpatient visits in primary care significantly declined from 63% in 2005 to 59% in 2013 (P ‫؍‬ .002). In Western China it went down from 66% in 2010 to 62% in 2013 (P ‫؍‬ .017) and slightly dropped in Eastern and Central China. Causes are multiple and include major historic and institutional factors such as severe maldistribution of human resources and lack of primary care practitioners (PCPs), lack of a functional gate-keeping mechanism, the low educational attainment of PCPs, and the detrimental elements of health reforms. Immediate measures need to be taken to improve the situation. These include taking irrational hospital expansion under strict control through enhancing the government's accountability for health care industry regulation, strategies to recruit and retain a quality primary care workforce, empowering PCPs as gatekeepers in the system, timely evaluation of the impact of health reforms on primary care, and modifying damaging policies. ( J Am Board Fam Med 2016;29:240 -247.)

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An evaluation of the policy on community health organizations in China: Will the priority of new healthcare reform in China be a success?

Cited by 112 publications

References 15 publications

Factors Associated With Traditional Chinese Medicine Utilization Among Urban Community Health Centers in Hubei Province of China

Factors Associated With Traditional Chinese Medicine Utilization Among Urban Community Health Centers in Hubei Province of China

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

Underuse of Primary Care in China: The Scale, Causes, and Solutions

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