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Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example

BACKGROUND: To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to...

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Autores principales: Li, Tongtong, Lei, Trudy, Xie, Zheng, Zhang, Tuohong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743421/
https://www.ncbi.nlm.nih.gov/pubmed/26846921
http://dx.doi.org/10.1186/s12913-016-1276-y
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author Li, Tongtong
Lei, Trudy
Xie, Zheng
Zhang, Tuohong
author_facet Li, Tongtong
Lei, Trudy
Xie, Zheng
Zhang, Tuohong
author_sort Li, Tongtong
collection PubMed
description BACKGROUND: To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors’ basic public health services provision and to formulate targeted interventions in rural China. METHODS: Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models. RESULTS: The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2 % among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937–7.678, and OR = 4.027, 95 % CI: 1.722–9.420), being under integrated management (OR = 1.978, 95 % CI: 1.132–3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95 % CI: 1.187–3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100). CONCLUSION: Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1276-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-47434212016-02-06 Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example Li, Tongtong Lei, Trudy Xie, Zheng Zhang, Tuohong BMC Health Serv Res Research Article BACKGROUND: To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors’ basic public health services provision and to formulate targeted interventions in rural China. METHODS: Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models. RESULTS: The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2 % among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937–7.678, and OR = 4.027, 95 % CI: 1.722–9.420), being under integrated management (OR = 1.978, 95 % CI: 1.132–3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95 % CI: 1.187–3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100). CONCLUSION: Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1276-y) contains supplementary material, which is available to authorized users. BioMed Central 2016-02-04 /pmc/articles/PMC4743421/ /pubmed/26846921 http://dx.doi.org/10.1186/s12913-016-1276-y Text en © Li et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Li, Tongtong
Lei, Trudy
Xie, Zheng
Zhang, Tuohong
Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example
title Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example
title_full Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example
title_fullStr Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example
title_full_unstemmed Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example
title_short Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example
title_sort determinants of basic public health services provision by village doctors in china: using non-communicable diseases management as an example
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743421/
https://www.ncbi.nlm.nih.gov/pubmed/26846921
http://dx.doi.org/10.1186/s12913-016-1276-y
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