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Evolution of primary care in China 1997–2009

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  • Bhattacharyya, Onil
  • Delu, Yin
  • Wong, Sabrina T.
  • Bowen, Chen

Abstract

Primary health care, once the cornerstone of China's health system, has been neglected in the country's market-oriented system. Recent primary care reform was designed to improve access, quality and efficiency of health service use, but the results are unclear. The government is dramatically increasing funding for community health services, but there is concern about maximizing the impact of this investment. This paper draws on policy analysis, literature review, and a secondary analysis of two case studies and two surveys to review the structure of community health services and public reaction to them. Our results suggest that despite several years of primary care reform, current performance remains poor. The capacity of providers is low, services are not felt to be affordable, and patients report concerns about safety, all contributing to low utilization of community health facilities. We argue that the minimum skill set for community health service providers should be clearly defined to focus training efforts as should the role of community health facilities within the health system. Moreover, a quality and accountability framework for community health service is needed so that increased funding can produce a strong foundation for China's health system.

Suggested Citation

  • Bhattacharyya, Onil & Delu, Yin & Wong, Sabrina T. & Bowen, Chen, 2011. "Evolution of primary care in China 1997–2009," Health Policy, Elsevier, vol. 100(2), pages 174-180.
    • Handle: RePEc:eee:hepoli:v:100:y:2011:i:2:p:174-180
    DOI: 10.1016/j.healthpol.2010.11.005
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    References listed on IDEAS

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    5. Jiazhi Zeng & Leiyu Shi & Xia Zou & Wen Chen & Li Ling, 2015. "Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-21, October.
    6. Yang, Miaoqing, 2018. "Demand for social health insurance: Evidence from the Chinese New Rural Cooperative Medical Scheme," China Economic Review, Elsevier, vol. 52(C), pages 126-135.
    7. Bo Li & Juan Chen, 2022. "Barriers to Community-Based Primary Health Care Delivery in Urban China: A Systematic Mapping Review," IJERPH, MDPI, vol. 19(19), pages 1-18, October.
    8. Xiao Tan & Lei Yu, 2022. "Has recentralisation improved equality? Primary care infrastructure development in China," Asia and the Pacific Policy Studies, Wiley Blackwell, vol. 9(2), pages 115-133, May.
    9. Huijie Yan, 2015. "The Integration of Energy, Environment and Health Policies in China: A Review," Working Papers halshs-01247183, HAL.
    10. Da Feng & Ray Serrano & Ting Ye & Shangfeng Tang & Lei Duan & Yuan Xu & Jian Yang & Yuan Liang & Shanquan Chen & Zhanchun Feng & Liang Zhang, 2016. "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," IJERPH, MDPI, vol. 13(12), pages 1-14, December.

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