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Are services delivered by community health centers more cost‐effective? Evidence from urban China

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  • Hongli Jiang
  • Wen Chen
  • Kangning Bi
  • Xiaohua Ying

Abstract

China has introduced a system of community health centers (CHCs) to provide primary care. To test whether services provided by such centers are more cost‐effective than treatment at local higher‐level hospitals, the study compared health outcomes and expenditures for patients with hypertension and diabetes mellitus in three cities. We hypothesized that treating patients in stable condition at CHCs is less costly than providing treatment in higher‐level hospitals with no differences in health outcomes. Results indicate that daily drug and other medical expenditures were consistently equal or lower for patients seeking treatment in CHCs than for those treated in hospitals. Patients also saved time by visiting CHCs. Health outcomes, measured as mean arterial pressure for hypertension and plasma glucose for diabetes, were similar for patients seeking treatment in CHCs and hospitals in most cases. Results suggest that CHCs are more cost‐effective than hospitals in treating chronic diseases. Findings may also indicate that those patients seeking care at hospitals have more serious – and therefore more expensive and time‐consuming – conditions. Further empirical research is needed to clarify these results. Copyright © 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • Hongli Jiang & Wen Chen & Kangning Bi & Xiaohua Ying, 2009. "Are services delivered by community health centers more cost‐effective? Evidence from urban China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 107-117, July.
    • Handle: RePEc:wly:hlthec:v:18:y:2009:i:s2:p:s107-s117
    DOI: 10.1002/hec.1517
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    Cited by:

    1. Yun Chai & Hancheng Xu & Wenxin Wang & Bing Liu & Dehua Yang & Hong Fan & Fujian Song & Zuxun Lu, 2011. "A Survey of Factors Associated with the Utilization of Community Health Centers for Managing Hypertensive Patients in Chengdu, China," PLOS ONE, Public Library of Science, vol. 6(7), pages 1-7, July.
    2. Tiantian Tao & Lili Hou & Rong Shao, 2021. "Factors associated with the choice of primary treatment at the community level among the middle‐aged and elderly in China," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(2), pages 442-458, March.
    3. Xiaolin Wei & Haitao Li & Nan Yang & Samuel Y S Wong & Onikepe Owolabi & Jianguang Xu & Leiyu Shi & Jinling Tang & Donald Li & Sian M Griffiths, 2015. "Comparing Quality of Public Primary Care between Hong Kong and Shanghai Using Validated Patient Assessment Tools," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-15, March.
    4. Yanwei Ding & Jianwei Qu & Xiaosong Yu & Shuang Wang, 2014. "The Mediating Effects of Burnout on the Relationship between Anxiety Symptoms and Occupational Stress among Community Healthcare Workers in China: A Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-7, September.

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