ArticleBulletin of the World Health Organization2015
Changes in the perceived quality of primary care in Shanghai and Shenzhen, China: a difference-in-difference analysis.
Article in Bulletin of the World Health Organization, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers, 4 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Health and health system impacts of China's comprehensive primary healthcare reforms: a systematic review.Health policy and planning · 2023Pooled it
- Primary healthcare reform for chronic conditions in countries with high or very high human development index: A systematic review.Chronic illness · 2022Pooled it
- Payment methods for healthcare providers working in outpatient healthcare settings.The Cochrane database of systematic reviews · 2021Pooled it
- What are the similarities and differences in structure and function among the three main models of community health centers in China: a systematic review.BMC health services research · 2015Pooled it
- Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China.PloS one · 2015Trial
- Patient-centered medical home and the quality of primary care: survey study with patients and administrators of community healthcare centers in Shanghai, China.BMC primary care · 2025Article
- Performance-based payments and intrinsic motivation among primary healthcare workers in China: a cross-sectional survey.BMJ open · 2025Article
- Article
- Impact of the hierarchical medical system on the perceived quality of primary care in China: a quasi-experimental study.Global health research and policy · 2025Article
- Public mental health services in Southern China and related health outcomes among individuals living with severe mental illness.Global health research and policy · 2024Article
- Associations between Primary Healthcare Experiences and Glycemic Control Status in Patients with Diabetes: Results from the Greater Bay Area Study, China.International journal of environmental research and public health · 2023Article
- Attributes of primary health care in Mato Grosso do Sul state: PCAT-Brazil paired for users and health professionals, 2018.BMC health services research · 2022Article
- The trend in primary health care preference in China: a cohort study of 12,508 residents from 2012 to 2018.BMC health services research · 2021Article
- Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study.International journal of environmental research and public health · 2021Article
- Effectiveness of primary care gatekeeping: difference-in-differences evaluation of a pilot scheme in China.BMJ global health · 2020Article
- Physical multimorbidity, health service use, and catastrophic health expenditure by socioeconomic groups in China: an analysis of population-based panel data.The Lancet. Global health · 2020Article
- Epidemiological characteristics and disease spectrum of emergency patients in two cities in China: Hong Kong and Shenzhen.World journal of emergency medicine · 2020Article
- Following the legacy of professors Barbara Starfield and Leiyu Shi in Brazil as health policy: the National Health Survey (PNS), led by the Brazilian National Institute of Geography and Statistics (IBGE) and the Primary Care Assessment Tool (PCAT).International journal for equity in health · 2019Review
- Development of primary care assessment tool-adult version in Tibet: implication for low- and middle-income countries.Primary health care research & development · 2019Article
- Evaluating Primary Health Care Performance from User Perspective in China: Review of Survey Instruments and Implementation Issues.International journal of environmental research and public health · 2019Review
Corrections and comments
- Erratum issuedCorrigendum.2015
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess changes in the quality of primary care in two megacities following the introduction of health system reforms in China.
methodsWe conducted multistage stratified random face-to-face surveys of patients visiting community health centres in Shanghai in 2011 and 2013, and Shenzhen in 2012 and 2013. Quality of primary care was measured using an assessment tool. Difference-in-difference analyses based on multiple linear regressions were used to compare the changes over time, after controlling for potential confounders.
findingsMost (2721) of the 3214 participants used a community health centre as their regular source of care and were included in our analyses. The mean total scores for quality of primary care were similar for Shanghai and Shenzhen at baseline. In Shenzhen, the mean total scores for all participants and those on low incomes had worsened by 0.922 (95% CI: 0.629 to 1.215) and 1.203 (95% CI: 0.397 to 2.009), respectively. In Shanghai, however, there were improvements in the mean total scores which included increases in the scores for first-contact utilization, continuity, coordination of information and comprehensiveness.
conclusionThe quality of primary care improved in Shanghai but not in Shenzhen. This may be because, in Shanghai, beneficial long-term relationships between patients and general practitioners were supported by capitation payments and the provision of services tailored to the local health priorities.
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