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Development trend of primary healthcare after health reform in China: a longitudinal observational study

OBJECTIVES: Reconstructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on the strengthening of primary healthcare in Chinese health system. DESIGN: This study was a longitudinal observational study. PRIMARY...

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Autores principales: Feng, Jie, Gong, Yanhong, Li, Hui, Wu, Jianxiong, Lu, Zuxun, Zhang, Guopeng, Zhou, Xuan, Yin, Xiaoxv
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9185408/
https://www.ncbi.nlm.nih.gov/pubmed/35676005
http://dx.doi.org/10.1136/bmjopen-2021-052239
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author Feng, Jie
Gong, Yanhong
Li, Hui
Wu, Jianxiong
Lu, Zuxun
Zhang, Guopeng
Zhou, Xuan
Yin, Xiaoxv
author_facet Feng, Jie
Gong, Yanhong
Li, Hui
Wu, Jianxiong
Lu, Zuxun
Zhang, Guopeng
Zhou, Xuan
Yin, Xiaoxv
author_sort Feng, Jie
collection PubMed
description OBJECTIVES: Reconstructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on the strengthening of primary healthcare in Chinese health system. DESIGN: This study was a longitudinal observational study. PRIMARY AND SECONDARY OUTCOME MEASURES: The data of this study came from China Health Statistical Yearbook (2009–2018). We evaluated the development of primary healthcare based on the absolute values of health resources allocation and health service provision and evaluated the status of primary healthcare throughout the health system based on the composition ratios of the indicators across the health system. The Cochran-Armitage trend test and linear trend test were used to identify the indicators’ trends over time. RESULTS: From 2009 to 2018, the amounts of health resources allocation and health service provision of Chinese primary healthcare institutions showed a significant upward trend (p<0.001). However, compared with the indicators in 2009, excepting that the proportion of grants from the government in the whole health system has an upward trend, the proportions of other indicators had an escalating trend in 2018 by 3.66% for practicing (assistant) physicians, by 2.69% for nurses, by 3.99% for total revenues, by 5.87% for beds, by 8.39% for outpatient visits. CONCLUSION: The primary healthcare system has developed rapidly, but its development speed lagged behind the entire health system, resulting in the weakening of its actual functions, which is not in line with the goal of health reform. The government should be more aware of the importance of primary healthcare at all levels of local governments and ensure adequate financial input.
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spelling pubmed-91854082022-06-16 Development trend of primary healthcare after health reform in China: a longitudinal observational study Feng, Jie Gong, Yanhong Li, Hui Wu, Jianxiong Lu, Zuxun Zhang, Guopeng Zhou, Xuan Yin, Xiaoxv BMJ Open Health Policy OBJECTIVES: Reconstructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on the strengthening of primary healthcare in Chinese health system. DESIGN: This study was a longitudinal observational study. PRIMARY AND SECONDARY OUTCOME MEASURES: The data of this study came from China Health Statistical Yearbook (2009–2018). We evaluated the development of primary healthcare based on the absolute values of health resources allocation and health service provision and evaluated the status of primary healthcare throughout the health system based on the composition ratios of the indicators across the health system. The Cochran-Armitage trend test and linear trend test were used to identify the indicators’ trends over time. RESULTS: From 2009 to 2018, the amounts of health resources allocation and health service provision of Chinese primary healthcare institutions showed a significant upward trend (p<0.001). However, compared with the indicators in 2009, excepting that the proportion of grants from the government in the whole health system has an upward trend, the proportions of other indicators had an escalating trend in 2018 by 3.66% for practicing (assistant) physicians, by 2.69% for nurses, by 3.99% for total revenues, by 5.87% for beds, by 8.39% for outpatient visits. CONCLUSION: The primary healthcare system has developed rapidly, but its development speed lagged behind the entire health system, resulting in the weakening of its actual functions, which is not in line with the goal of health reform. The government should be more aware of the importance of primary healthcare at all levels of local governments and ensure adequate financial input. BMJ Publishing Group 2022-06-08 /pmc/articles/PMC9185408/ /pubmed/35676005 http://dx.doi.org/10.1136/bmjopen-2021-052239 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Health Policy
Feng, Jie
Gong, Yanhong
Li, Hui
Wu, Jianxiong
Lu, Zuxun
Zhang, Guopeng
Zhou, Xuan
Yin, Xiaoxv
Development trend of primary healthcare after health reform in China: a longitudinal observational study
title Development trend of primary healthcare after health reform in China: a longitudinal observational study
title_full Development trend of primary healthcare after health reform in China: a longitudinal observational study
title_fullStr Development trend of primary healthcare after health reform in China: a longitudinal observational study
title_full_unstemmed Development trend of primary healthcare after health reform in China: a longitudinal observational study
title_short Development trend of primary healthcare after health reform in China: a longitudinal observational study
title_sort development trend of primary healthcare after health reform in china: a longitudinal observational study
topic Health Policy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9185408/
https://www.ncbi.nlm.nih.gov/pubmed/35676005
http://dx.doi.org/10.1136/bmjopen-2021-052239
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