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Barriers to Community-Based Primary Health Care Delivery in Urban China: A Systematic Mapping Review

Author

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  • Bo Li

    (Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China)

  • Juan Chen

    (Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
    Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong, China)

Abstract

Providing access to a range of basic health services, community-based primary health care (CB-PHC) plays a vital role in achieving the goal of health for all. Driven by a strong political commitment, China’s CB-PHC progress in the past decade has been swift and impressive. However, a well-functioning delivery system for care has yet to be established. This systematic mapping review synthesizes selected evidence on barriers to CB-PHC delivery in urban China and draws lessons for policy development. We performed searches on five electronic databases: CINAHL, MEDLINE, Scopus, Web of Science, and China National Knowledge Infrastructure, and included studies published between 2012 and 2021. The Downs and Black and Critical Appraisal Skills Program checklists were used to assess the quality of eligible papers. We conducted our searches and syntheses following the framework set out in the Primary Health Care Performance Initiative (PHCPI). We synthesized the results of the included studies using a thematic narrative approach and reported according to PRISMA guidelines. Six salient barriers arose from our syntheses of 67 papers: lack of comprehensive health insurance schemes, lack of public awareness, superficial care relationships, gaps in communication, staff shortages and poor training, and second-rate equipment. These barriers are grouped into three subdomains following the PHCPI framework: access, people-centered care, and organization and management. A host of negative impacts of these barriers on community-based health care were also identified. It was not possible to determine clear causes of these barriers from the contributing evidence because of the lack of conceptual frameworks and research methods constraints. Non-eastern regions of China and access-related barriers require further exploration. It follows that, at the national level, the problems are likely more severe than the research suggests.

Suggested Citation

  • 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.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12701-:d:933407
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    References listed on IDEAS

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    1. Zining Xia & WenJuan Gao & Xuejuan Wei & Yingchun Peng & Hongjun Ran & Hao Wu & Chaojie Liu, 2020. "Perceived Value of Electronic Medical Records in Community Health Services: A National Cross-Sectional Survey of Primary Care Workers in Mainland China," IJERPH, MDPI, vol. 17(22), pages 1-19, November.
    2. Bhattacharyya, Onil & Delu, Yin & Wong, Sabrina T. & Bowen, Chen, 2011. "Evolution of primary care in China 1997-2009," Health Policy, Elsevier, vol. 100(2-3), pages 174-180, May.
    3. Huazhang Li & Kun Liu & Jianjun Gu & Yimin Zhang & Yun Qiao & Xiaoming Sun, 2017. "The development and impact of primary health care in China from 1949 to 2015: A focused review," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(3), pages 339-350, July.
    4. Tao Zhang & Jianping Ren & Xinyu Zhang & Wendy Max, 2020. "Medical and socio‐demographic characteristics associated with patient‐perceived continuity of primary care: A cross‐sectional survey in Hangzhou, China," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(2), pages 569-580, March.
    5. Peng Yue & Tianmeng Xu & Brian Greene & Yongli Wang & Rongjin Wang & Guizhi Dai & Lijie Xu, 2020. "Caring in community nursing practice: Inductive content analysis reveals an inter‐dynamic system between patients and nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(15-16), pages 3025-3041, August.
    6. 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.
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    1. Li, Bo & Chen, Juan & Howard, Natasha, 2023. "Community nursing delivery in urban China: A social power perspective," Social Science & Medicine, Elsevier, vol. 326(C).

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