Are Rural Primary Care Providers Able to Competently Manage Common Illnesses? A Cross-Sectional Study in Rural Sichuan, Western China

Abstract

Background: Strengthening primary care is a key focus of the latest healthcare reforms in China. However, many challenges, including the workforce competence, still exist. This study aimed to evaluate the common disease management competency of rural primary care providers in Sichuan Province, western China. Methods: A cross-sectional study was conducted in 9 township health centers and 86 village clinics in 3 counties. Diarrhea and respiratory infection were selected as the evaluation cases. General partitioners were assessed through their abilities to (1) take history; (2) make diagnoses; (3) propose treatment; and (4) deal with clinical cases. Results: In total, 362 healthcare workers were surveyed, and 130 general practitioners were enrolled into our study. On average, rural primary care providers could only answer 46.4% of questions absolutely correctly, with 29.7% partly correctly and 23.8% incorrectly. Conclusion: We suggest strengthening training to improve rural primary care providers’ competencies, especially their capacities of history taking. Policy action is also needed to address regional disparities.

Examining clinical capability of township healthcare centres for rural health service planning in Sichuan, China: an administrative data analysis

“…However, realising the implications would involve understanding the difference in quality and safety between hospitals for the specific diseases in the two levels, which presents an important research area in near future. 21 …”

“…Keeping patients in the care of THCs for diseases treatable by both THCs and CHs has a number of important implications in reducing care cost of both patients and insurance agency or government,33 in establishing a practical gate-keeping procedure of the THCs,34 in setting up integrated continuous care plan of patients after discharge35 and in strengthening capability of THCs. However, realising the implications would involve understanding the difference in quality and safety between hospitals for the specific diseases in the two levels, which presents an important research area in near future 21…”

“…This study aimed to fill the gaps by examining the clinical capability of THCs and comparing it with local CHs. Considering that clinical capability by definition is a multiple-dimensional system, we previously reported quality of outpatient services of the sampled THCs, 21 and of workload in preventive care in the study THCs. 22 Hence, this study only focused on scope of inpatient services as a narrow proxy of clinical capability to reflect the coverage of the curative care of THCs.…”