ArticleBMJ global health2021
Factors affecting health care users' first contact with primary health care facilities in north eastern China, 2008-2018.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Third-party governance and artificial intelligence for diabetes management in primary health care, China.Bulletin of the World Health Organization · 2026Article
- Reducing Primary Healthcare Bypass Behaviour: A Discrete Choice Experiment Study Exploring the Preferences for Primary Eye Care Services in Rural Xinjiang.The patient · 2026Article
- Why do they sign but not consult? A study on the effectiveness of China's family doctor contract services from the perspective of patient-doctor interaction.Frontiers in medicine · 2026Article
- Temporal Trends in Patient Choice of Outpatient Care Provider Among Vietnam's Insured Rural Residents, 2006-2020.The International journal of health planning and management · 2025Article
- Association between family doctor contract services and management status among patients with hypertension or diabetes in a multi-ethnic Province of China.BMC primary care · 2025Article
- Community participation and contracting between state and non-state actors in primary care: A scoping review of evidence.International journal for equity in health · 2025Article
- Impact of a new case-based payment scheme on volume distribution across public hospitals in Zhejiang, China: does 'Same disease, same price' matter.International journal for equity in health · 2025Article
- Impact of China's primary healthcare reforms on utilisation, payments and self-reported health: a quasi-experimental analysis of a middle-aged and older cohort 2011-2018.BMJ public health · 2025Article
- Community health workers' knowledge and attitudes toward advance directives in China: a cross-sectional study.Frontiers in public health · 2025Article
- Impact of family doctor system on diabetic patients with distinct service utilisation patterns: a difference-in-differences analysis based on group-based trajectory modelling.BMJ global health · 2024Article
- Does contracting family doctor promote primary healthcare utilization among older adults? - evidence from a difference-in-differences analysis.BMC geriatrics · 2024Article
- The role of perceived quality of care on outpatient visits to health centers in two rural districts of northeast Ethiopia: a community-based, cross-sectional study.BMC health services research · 2024Article
- Does a new case-based payment system promote the construction of the ordered health delivery system? Evidence from a pilot city in China.International journal for equity in health · 2024Article
- Factors influencing contracting of residents with family doctors in China: a national cross-sectional survey.BMC health services research · 2024Article
- Exploring the impact of water, sanitation and hygiene (WASH), early adequate feeding and access to health care on urban-rural disparities of child malnutrition in China.Maternal & child nutrition · 2023Article
- Shared-care models are highly effective and cost-effective for managing chronic hepatitis B in China: reinterpreting the primary care and specialty divide.The Lancet regional health. Western Pacific · 2023Article
- Effectiveness of hierarchical medical system policy: an interrupted time series analysis of a pilot scheme in China.Health policy and planning · 2023Article
- Tracking progress towards universal health coverage for essential health services in China, 2008-2018.BMJ global health · 2022Article
- Association between Primary Care Utilization and Emergency Room or Hospital Inpatient Services Utilization among the Middle-Aged and Elderly in a Self-Referral System: Evidence from the China Health and Retirement Longitudinal Study 2011-2018.International journal of environmental research and public health · 2022Article
- Levels, trends, and determinants of effectiveness on the hierarchical medical system in China: Data envelopment analysis and bootstrapping truncated regression analysis.Frontiers in public health · 2022Article
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Authors and funding
4 authors.
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Abstract
backgroundChina set out the vision to establishing a hierarchical medical system, with primary health care (PHC) facilities serving health care users' first contact. Common ailments were listed, supported by a series of auxiliary policy measures. We aim to assess whether these policies were effective to prompt users' preference to PHCs within these contexts.
methodsUsing data from three waves of National Health Service Survey, we examined trends in care users' first contact with PHC facilities in Jilin, a north eastern province, during 2008-2018. We analysed trends and factors affecting care users' choices, stratified by type of diseases and urban-rural settings.
resultsFrom 38 823 respondents, the survey identified 3302 health care users who sought outpatient care. 54.92% and 82.49% with diseases recommended to PHC, in urban and rural Jilin, respectively, contacted PHC facilities first. While 33.51% and 61.19% with diseases not recommended to PHC did so. Care users' first contact with PHC facilities followed an inverse U shape during 2008-2018. Such trends were more profound among care users with hypertension and/or diabetes. Neither social health insurance coverage nor contracting with family doctors was associated with care users' first contacts. Only 1.25% care users had referral experiences. Low perceived quality was the main barrier to choose PHC facilities.
conclusionHealth care users sought PHC in a chaotic manner in Jilin. None of the recent efforts seemed effective in prompting their preference to PHC facilities. Without levering quality of PHC, an effective hierarchical medical system could be hardly forged in China.
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