The development of urban community health centres for strengthening primary care in China: a systematic literature review

Wang, Haoxiang; Wang, Jia Ji; Wong, M.W.T.; Mercer, Stewart W; Griffiths, Siân

doi:10.1093/bmb/ldv043

Cited by 60 publications

(96 citation statements)

References 35 publications

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“…To improve current efforts, providers may wish to examine the feasibility of incorporating family/friends into their patient’s healthcare plans. To ensure stronger linkages between provider, household, and PLCDs, policymakers may want to shift their focus towards primary hospitals and seek to ensure that primary hospitals are the managers of long-term treatment plans [39]. This shift can be enabled through strategic mass media campaigns at the community level so as to enhance public awareness of localized chronic disease maintenance [39,40,41].…”

Section: Discussionmentioning

confidence: 99%

“…To ensure stronger linkages between provider, household, and PLCDs, policymakers may want to shift their focus towards primary hospitals and seek to ensure that primary hospitals are the managers of long-term treatment plans [39]. This shift can be enabled through strategic mass media campaigns at the community level so as to enhance public awareness of localized chronic disease maintenance [39,40,41]. Our study also found, consistent with other studies [14,42], that elderly participants sought health services more regularly than younger participants.…”

Section: Discussionmentioning

confidence: 99%

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What Contributes to the Regularity of Patients with Hypertension or Diabetes Seeking Health Services? A Pilot Follow-Up, Observational Study in Two Sites in Hubei Province, China

Feng

Serrano

et al. 2016

IJERPH

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Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in 2015 on diabetic and hypertensive patients in Hubei Province. We used binary logistic regression models to determine specific factors associated with diabetic and hypertensive patients that sought healthcare services for their conditions in accordance with current Chinese Centers for Disease Prevention and Control (CDC) guidelines. Our findings show that 42.16% of 510 people living with chronic conditions (PLCDs) sought health services in line with existing guidelines. Findings also show a higher probability (8.418 times) for PLCDs seeking healthcare services at higher-tiered hospitals (secondary and tertiary hospitals) than for PLCDs seeking care at primary hospitals (odds ratio (OR) = 8.418, 95% confidence interval (CI) = 4.82, 14.27, p < 0.001). These analyses underscore the importance of having patient advocates who can provide support, where necessary, and encourage positive health-seeking behavior. The study also shows a negative impact on regular maintenance for PLCDs in households with high financial constraints. In contrast, the study shows positive impacts for increased household income, age, and residency in rural locations. In sum, this study underscores the importance of primary hospitals as key points of care and critical players in care coordination for PLCDs. The study provides more evidence for Chinese policymakers seeking to contain costs and improve population health. The findings also underscore the need for community-based interventions, specifically interventions that link local primary hospitals, friends/family members, and PLCDs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What Contributes to the Regularity of Patients with Hypertension or Diabetes Seeking Health Services? A Pilot Follow-Up, Observational Study in Two Sites in Hubei Province, China

Feng

Serrano

et al. 2016

IJERPH

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“…Previous studies have shown a much lower prevalence of exclusive breastfeeding in infants—35% of infants under 4 months of age were exclusively breastfed in Jinan City, China (2000) [8]; less than 5% infants were exclusively breastfed in the first 6 months of life in Zhejiang province, China (2005) [9]; and 28.7% of infants younger than 6 months of age were exclusively breastfed in twelve central and western provinces (2009) [10]. China initiated the National Basic Public Health Service Program in 2009 to improve essential public health services (including promotion of breastfeeding) in both urban and rural areas [11,12,13]. Only three studies have updated the recent national or local data on the prevalence of breastfeeding.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Breastfeeding: Findings from the First Health Service Household Interview in Hunan Province, China

Qin

Zhang

et al. 2017

IJERPH

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Background: With the development of economy and urbanization, methods of child-feeding have significantly changed in China over the past three decades. However, little is known about breastfeeding in China since 2009. This study aims to update information on the prevalence of breastfeeding in China. Methods: Data were obtained from the first Health Service Household Interview Survey of Hunan Province, China. Of 24,282 respondents, 1659 were aged five years or younger. We ran multivariable logistic regression to examine the impact of urban/rural setting, gender, age and household income per capita on the use of breastfeeding. Results: A total of 79.4% of children aged 5 years or younger had been breastfed at some point and 44.9% been breastfed exclusively in the first 6 months of life. After controlling for setting urban/rural setting, gender and child age, children from households with average family income were more likely to be breastfed than those from households with the lowest family income (adjusted odds ratio: 2.28). Children from households with higher and the highest family income were less likely to be exclusively breastfed in the first 6 months of life compared to those from households with the lowest family income (adjusted odds ratio: 0.51 and 0.68, respectively). Conclusions: It is encouraging that the prevalence of exclusive breastfeeding for infants in the first 6 months of life in Hunan Province, China is approaching the goal of 50% proposed by the World Health Organization (WHO). Nevertheless, more efforts are needed to further promote exclusive breastfeeding in the first 6 months after birth.

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“…The degree of this limitation usually depends on the performance of the health care system in place: The more sophisticated the health care system, the more regulations are in place, which in turn limits the GPs practice location choices. China for example has a rather weak primary care system, whereas the United Kingdom and Germany have a rather strong primary care system [6, 22]. Bearing this in mind, our results only reflect the situation in a developed health care setting.…”

Section: Discussionmentioning

confidence: 82%

“…In this context, little is known about the factors associated with settlement decisions of GPs in metropolises. So far, numerous studies have focused on urban vs. rural comparisons of GP distribution and their impact on health inequity [16–22]. Only few studies have investigated metropolitan areas in Germany [23, 24].…”

Section: Introductionmentioning

confidence: 99%

General practitioners in German metropolitan areas – distribution patterns and their relationship with area level measures of the socioeconomic status

Bauer

Brueggmann

Ohlendorf

et al. 2016

BMC Health Serv Res

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BackgroundGeographical variation of the general practitioner (GP) workforce is known between rural and urban areas. However, data about the variation between and within urban areas are lacking.MethodWe analyzed distribution patterns of GP full time equivalents (FTE) in German cities with a population size of more than 500,000. We correlated their distribution with area measures of social deprivation in order to analyze preferences within neighborhood characteristics. For this purpose, we developed two area measures of deprivation: Geodemographic Index (GDI) and Cultureeconomic Index (CEI).ResultsIn total n = 9034.75 FTE were included in n = 14 cities with n = 171 districts. FTE were distributed equally on inter-city level (mean: 6.49; range: 5.12–7.20; SD: 0.51). However, on intra-city level, GP distribution was skewed (mean: 6.54; range: 1.80–43.98; SD: 3.62). Distribution patterns of FTE per 10^4 residents were significantly correlated with GDI (r = −0.49; p < 0.001) and CEI (r = −0.22; p = 0.005). Therefore, location choices of GPs were mainly positively correlated with 1) central location (r = −0.50; p < 0.001), 2) small household size of population (r = −0.50; p < 0.001) and 3) population density (r = 0.35; p < 0.001).ConclusionIntra-city distribution of GPs was skewed, which could affect the equality of access for the urban population. Furthermore, health services planners should be aware of GP location preferences. This could be helpful to better understand and plan delivery of health services. Within this process the presented Geodemographic Index (GDI) could be of use.

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The development of urban community health centres for strengthening primary care in China: a systematic literature review

Abstract: Future prospective studies should aim to provide solutions for strengthening the leading role of CHCs in providing equitable care in response to population ageing and multimorbidity challenges.

Cited by 60 publications

References 35 publications

What Contributes to the Regularity of Patients with Hypertension or Diabetes Seeking Health Services? A Pilot Follow-Up, Observational Study in Two Sites in Hubei Province, China

What Contributes to the Regularity of Patients with Hypertension or Diabetes Seeking Health Services? A Pilot Follow-Up, Observational Study in Two Sites in Hubei Province, China

Prevalence of Breastfeeding: Findings from the First Health Service Household Interview in Hunan Province, China

General practitioners in German metropolitan areas – distribution patterns and their relationship with area level measures of the socioeconomic status

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