ArticleSocial science & medicine (1982)2022
Explaining the declining utilization of village clinics in rural China over time: A decomposition approach.
Article in Social science & medicine (1982), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- "It sounds unfamiliar, yet appealing": a qualitative study on perceptions of a good death and hospice care needs among older adults in remote rural China.BMC palliative care · 2026Article
- Assessing the relationship between the hospital grading system and medical resource utilization: evidence from China.Cost effectiveness and resource allocation : C/E · 2026Article
- The impact of digital economy on primary healthcare institution efficiency: evidence from China based on spatial effect analysis.BMC primary care · 2026Article
- Impact of the compact county medical service community policy on healthcare resource allocation and healthcare service utilization in village clinics: a difference-in-differences analysis in rural Sichuan, China.Frontiers in public health · 2026Article
- Artificial intelligence in Chinese healthcare: a review of applications and future prospects.Biomedical engineering letters · 2025Review
- Geographic disparities in inpatient service in primary care and patients' choice of first point of consultation: a linked cross-sectional survey and administrative data analysis in Shaanxi of China.International journal for equity in health · 2025Article
- 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
- Efficiency analysis of primary health care resources: DEA and Tobit regression evidence from village clinics in Jiangsu Province.Frontiers in public health · 2025Article
- Uneven primary healthcare supply of rural doctors and medical equipment in remote China: community impact and the moderating effect of policy intervention.International journal for equity in health · 2024Article
- Impact of mobile Internet use on health-seeking behaviors: evidence from China.Frontiers in public health · 2024Article
- Technical efficiency and its convergence among village clinics in rural China: evidence from Shanxi Province.Frontiers in public health · 2024Article
- Quality of primary health care for chronic diseases in low-resource settings: Evidence from a comprehensive study in rural China.PloS one · 2024Article
- Cervical cancer screening aided by artificial intelligence, China.Bulletin of the World Health Organization · 2023Article
- The Role of Village Doctors in Residents' Uptake of Eye Screening: Evidence from Ageing Residents in Rural China.Healthcare (Basel, Switzerland) · 2022Article
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4 authors.
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Abstract
With a goal of improving health system quality and efficiency, reforms of China's health system over the past decade have sought to strengthen primary healthcare in lower-level clinics and health centers. Despite these wide-ranging reforms and initiatives, population-based studies have documented dramatic declines in patients' use of primary care facilities during this period. In this paper, we explore the determinants of this trend in China's rural areas using detailed longitudinal data following a nationally-representative sample of rural households and village clinics from 2011 to 2018. We estimate that between 2011 and 2018, the probability that individuals sought care at village clinics when ill dropped by 44%. At the same time, the utilization of outpatient services in county hospitals increased by 56% and patient self-treatment increased by 20%. Detailed Kitagawa-Oaxaca-Blinder decompositions suggest four primary drivers of this trend: the shifting burden of disease in rural areas, changes in how patients choose to seek care given different disease conditions, declining drug inventory in village clinics, and the decreasing importance of remoteness as a determinant of healthcare seeking behavior. Our results highlight the deteriorating role of village clinics in the rural healthcare system and the increasing importance of self-treatment and higher-tier primary care services.
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