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Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings

Primary health care (PHC) systems are compromised by under-resourcing and inadequate governance, and fail to provide high-quality health care services in most low- and middle-income countries (LMICs). As a response to solve the problems of underfunding and understaffing, Pengshui County, an impoveri...

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Detalles Bibliográficos
Autores principales: Zeng, Zhi, Tao, Wenjuan, Ding, Shanlong, Fang, Jianlong, Wen, Jin, Yao, Jianhong, Zhang, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323543/
https://www.ncbi.nlm.nih.gov/pubmed/35886206
http://dx.doi.org/10.3390/ijerph19148356
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author Zeng, Zhi
Tao, Wenjuan
Ding, Shanlong
Fang, Jianlong
Wen, Jin
Yao, Jianhong
Zhang, Wei
author_facet Zeng, Zhi
Tao, Wenjuan
Ding, Shanlong
Fang, Jianlong
Wen, Jin
Yao, Jianhong
Zhang, Wei
author_sort Zeng, Zhi
collection PubMed
description Primary health care (PHC) systems are compromised by under-resourcing and inadequate governance, and fail to provide high-quality health care services in most low- and middle-income countries (LMICs). As a response to solve the problems of underfunding and understaffing, Pengshui County, an impoverished area in rural Chongqing, China, implemented a profound reform of its PHC delivery system in 2009, focusing on horizontal integration and financing mechanisms. This paper aims to present new evidence from the Pengshui model, and to assess the relevant changes over the past 10 years (2009–2018). An inductive approach was adopted, based on analysis of national and local policy documents and administrative data. From 2009 to 2018, the proportion of outpatients who sought first-contact care in rural community or township health centers increased from 29% (522,700 of 1,817,600) in 2009, to 40% (849,900 of 2,147,800) in 2018 (the national average in 2018 was 23%). Our findings suggest that many positive results have been achieved through the reform, and that innovations in financial governance and incentive mechanisms are the main driving forces behind the improvement. Pengshui County’s experience has proven to be a successful experiment, particularly in rural and low-income areas.
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spelling pubmed-93235432022-07-27 Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings Zeng, Zhi Tao, Wenjuan Ding, Shanlong Fang, Jianlong Wen, Jin Yao, Jianhong Zhang, Wei Int J Environ Res Public Health Article Primary health care (PHC) systems are compromised by under-resourcing and inadequate governance, and fail to provide high-quality health care services in most low- and middle-income countries (LMICs). As a response to solve the problems of underfunding and understaffing, Pengshui County, an impoverished area in rural Chongqing, China, implemented a profound reform of its PHC delivery system in 2009, focusing on horizontal integration and financing mechanisms. This paper aims to present new evidence from the Pengshui model, and to assess the relevant changes over the past 10 years (2009–2018). An inductive approach was adopted, based on analysis of national and local policy documents and administrative data. From 2009 to 2018, the proportion of outpatients who sought first-contact care in rural community or township health centers increased from 29% (522,700 of 1,817,600) in 2009, to 40% (849,900 of 2,147,800) in 2018 (the national average in 2018 was 23%). Our findings suggest that many positive results have been achieved through the reform, and that innovations in financial governance and incentive mechanisms are the main driving forces behind the improvement. Pengshui County’s experience has proven to be a successful experiment, particularly in rural and low-income areas. MDPI 2022-07-08 /pmc/articles/PMC9323543/ /pubmed/35886206 http://dx.doi.org/10.3390/ijerph19148356 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zeng, Zhi
Tao, Wenjuan
Ding, Shanlong
Fang, Jianlong
Wen, Jin
Yao, Jianhong
Zhang, Wei
Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings
title Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings
title_full Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings
title_fullStr Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings
title_full_unstemmed Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings
title_short Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings
title_sort horizontal integration and financing reform of rural primary care in china: a model for low-resource and remote settings
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323543/
https://www.ncbi.nlm.nih.gov/pubmed/35886206
http://dx.doi.org/10.3390/ijerph19148356
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