ArticleBMC health services research2021
The impact of COVID-19 on primary health care and antibiotic prescribing in rural China: qualitative study.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 23 citations in OpenAlex.
- The equivalent value (EV)-based workload assessment of primary healthcare workers in Beijing, China.Human resources for health · 2025Article
- The performance of primary health care in the management of the Covid-19 in Iran and the existing challenges and strategies on the way to confront the pandemics: A qualitative study.Journal of education and health promotion · 2025Article
- Article
- Technical Efficiency Evaluation of Primary Health Care Institutions in Shenzhen, China, and Its Policy Implications under the COVID-19 Pandemic.International journal of environmental research and public health · 2023Article
- Of primary health care reforms and pandemic responses: understanding perspectives of health system actors in Kerala before and during COVID-19.BMC primary care · 2023Article
- COVID-19 preparedness and response in rural and remote areas: A scoping review.PLOS global public health · 2023Article
- Antibiotic use in township hospitals during the COVID-19 pandemic in Shandong, China.Antimicrobial resistance and infection control · 2022Article
- Development of China's health care system in the time of COVID-19: Challenges, opportunities, and call for actions.Health care science · 2022Article
- Antibiotic Use in China's Public Healthcare Institutions During the COVID-19 Pandemic: An Analysis of Nationwide Procurement Data, 2018-2020.Frontiers in pharmacology · 2022Article
- Application of Smartphone Otoscope in Telemedicine in Rural Medical Consortium in Eastern China in the COVID-19 Era.Frontiers in public health · 2022Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundIn China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China.
methodsQualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically.
resultsPHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged.
conclusionsThe COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.
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