Types of health care facilities and the quality of primary care: A study of characteristics and experiences of Chinese patients in Guangdong Province, China

Ruwei Hu, Yu Liao, Zhicheng Du, Yuantao Hao, Hailun Liang, Leiyu Shi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In China, most people tend to use hospitals rather than health centers for their primary care generally due to the perception that quality of care provided in the hospital setting is superior to that provided at the health centers. No studies have been conducted in China to compare the quality of primary care provided at different health care settings. The purpose of this study is to compare the quality of primary care provided in different types of health care facilities in China. Methods: A cross-sectional survey with patients was conducted in Guangdong province of China, using the validated Chinese Primary Care Assessment Tool (PCAT). ANOVA was performed to compare the overall and 10 domains of primary care quality for patients in tertiary, secondary, and primary health care settings. Multivariate analyses were used to assess the association between types of facility and quality of primary care attributes while controlling for sociodemographic and health care characteristics. Results: The final number of respondents was 864 including 161 from county hospitals, 190 from rural community health centers (CHCs), 164 from tertiary hospitals, 80 from secondary hospitals, and 269 from urban CHCs. Type of health care facilities was significantly associated with total PCAT score and domain scores. CHC was associated with higher total PCAT score and scores for first contact-access, ongoing care, comprehensiveness-services available, and community orientation than secondary and/or tertiary hospitals, after controlling for patients' demographic and health characteristics. Higher PCAT score was associated with greater satisfaction with primary care received. CHC patients were more likely to report satisfactory experiences compared to patients from secondary and tertiary facilities. Conclusions: The study demonstrated that CHCs provided better quality primary care when compared with secondary and tertiary health care facilities, justifying CHCs as a model of primary care delivery.

Original languageEnglish (US)
Article number335
JournalBMC health services research
Volume16
Issue number1
DOIs
StatePublished - Aug 2 2016

Keywords

  • Health policy
  • Health services development
  • Health systems
  • Quality assessment

ASJC Scopus subject areas

  • Health Policy

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