Evidence map›Paper›PMID 32505251›Full record

ReviewLancet (London, England)2020

Quality of primary health care in China: challenges and recommendations.

Xi Li, Harlan M Krumholz, Winnie Yip, Kar Keung Cheng, Jan De Maeseneer, Qingyue Meng, Elias Mossialos, Chuang Li, Jiapeng Lu, Meng Su and 22 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Lancet (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 539 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
539citing papers in PubMed, 2 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

539 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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479 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors.

Xi LiNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.
Harlan M KrumholzSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine and the Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.
Winnie YipDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Kar Keung ChengDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA; General Practice Development and Research Center, Peking University Health Science Center, Beijing, China.
Jan De MaeseneerDepartment of Public Health and Primary Care, Center of Family Medicine, Ghent University, Ghent, Belgium.
Qingyue MengSchool of Public Health, Peking University Health Science Center, Beijing, China.
Elias MossialosDepartment of Health Policy, London School of Economics and Political Science, Institute of Global Health Innovation, Imperial College London, London, UK.
Chuang LiHealth Commission of Shenzhen Municipality, Shenzhen, China.
Jiapeng LuNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.
Meng SuNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Qiuli ZhangNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Dong Roman XuSun Yat-sen Global Health Institute, Sun Yat-sen University School of Public Health, and Institute of State Governance, Guangzhou, China.
Liming LiSchool of Public Health, Peking University Health Science Center, Beijing, China.
Sharon-Lise T NormandDepartment of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Richard PetoNuffield Department of Population Health, University of Oxford, Oxford, UK.
Jing LiNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.
Zengwu WangNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Hongbing YanNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.
Runlin GaoNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Somsak ChunharasNational Health Foundation, Bangkok, Thailand.
Xin GaoXizhuangzi Village Clinic, Jinchang, China.
Raniero GuerraDirector General Office, WHO Headquarters, Geneva, Switzerland.
Huijie JiYaojia Township Primary Care Clinic, Zhengzhou, China.
Yang KeSchool of Oncology, Peking University Health Science Center, Beijing, China.
Zhigang PanDepartment of General Practice, Zhongshan Hospital of Shanghai Medical College Fudan University, Shanghai, China.
Xianping WuSichuan Center for Disease Control and Prevention, Chengdu, China.
Shuiyuan XiaoXiangya School of Public Health, Central South University, Changsha, China.
Xinying XieHealth Commission of Yunnan Province, Kumming, China.
Yujuan ZhangJijie Township Primary Care Clinic, Gejiu, China.
Jun ZhuNational Office for Maternal and Child Health Surveillance of China, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Shanzhu ZhuDepartment of General Practice, Zhongshan Hospital of Shanghai Medical College Fudan University, Shanghai, China.
Shengshou HuNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China. Electronic address: huss@fuwaihospital.org.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

China has substantially increased financial investment and introduced favourable policies for strengthening its primary health care system with core responsibilities in preventing and managing chronic diseases such as hypertension and emerging infectious diseases such as coronavirus disease 2019 (COVID-19). However, widespread gaps in the quality of primary health care still exist. In this Review, we aim to identify the causes for this poor quality, and provide policy recommendations. System challenges include: the suboptimal education and training of primary health-care practitioners, a fee-for-service payment system that incentivises testing and treatments over prevention, fragmentation of clinical care and public health service, and insufficient continuity of care throughout the entire health-care system. The following recommendations merit consideration: (1) enhancement of the quality of training for primary health-care physicians, (2) establishment of performance accountability to incentivise high-quality and high-value care; (3) integration of clinical care with the basic public health services, and (4) strengthening of the coordination between primary health-care institutions and hospitals. Additionally, China should consider modernising its primary health-care system through the establishment of a learning health system built on digital data and innovative technologies.

Indexed as

Quality of Health CareChinaContinuity of Patient CareCoronavirus InfectionsCOVID-19Fee-for-Service PlansHumansPandemicsPhysicians, Primary CarePneumonia, ViralPrimary Health Care

Identifiers

PMID32505251
PMCPMC7272159

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.