ArticlePloS one2024
Quality of primary health care for chronic diseases in low-resource settings: Evidence from a comprehensive study in rural China.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed.
- Assessment of the performance of primary healthcare in eight African countries: based on the Composite Fuzzy Index.BMJ global health · 2026Article
- Exploring long-term retention intention and influencing factors among rural-oriented medical students in primary care in Guangxi, China: a qualitative study.BMC health services research · 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
- An analysis and projection of diabetes prevalence in East England region.BMC public health · 2026Article
- Association rule mining and network analysis of the evolving comorbidity patterns in HIV inpatients in Baise, China.Frontiers in public health · 2026Article
- Factors influencing residents' willingness to choose medical institutions first for treatment in the highland agricultural and pastoral areas of Qinghai province: a study based on the Anderson model.Frontiers in health services · 2026Article
- Dietary perceptions and challenges in the management of type 2 diabetes in rural communities of the Eastern Cape, South Africa: a qualitative study.Frontiers in clinical diabetes and healthcare · 2026Article
- Article
- Intensified Multifaceted Education Improves the Implementation of Standard Atrial Fibrillation Care in Elderly Patients with Atrial Fibrillation in Rural China.Vascular health and risk management · 2025Article
- Facilitators and barriers in managing older chronic heart failure patients in community health care centers: a qualitative study of medical personnel's perspectives using the socio-ecological model.Frontiers in health services · 2025Article
- Whole-course quality of tuberculosis (TB) care in rural China: a retrospective study based on chart abstraction.BMJ open · 2024Observational
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12 authors.
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Abstract
backgroundThere is a paucity of evidence regarding the definition of the quality of primary health care (PHC) in China. This study aims to evaluate the PHC quality for chronic diseases in rural areas based on a modified conceptual framework tailored to the context of rural China.
methodsThis comprehensive study, involving a patient survey, a provider survey and chart abstraction, and second-hand registered data, was set in three low-resource counties in rural China from 2021 to 2022. Rural patients with hypertension or type 2 diabetes, and health care workers providing care on hypertension or diabetes were involved. The modified PHC quality framework encompasses three core domains: a competent PHC system (comprehensiveness, accessibility, continuity, and coordination), effective clinical care (assessment, diagnosis, treatment, disease management, and provider competence), and positive user experience (information sharing, shared decision-making, respect for patient's preferences, and family-centeredness). Standardized PHC quality score was generated by arithmetic means or Rasch models of Item Response Theory.
resultsThis study included 1355 patients, 333 health care providers and 2203 medical records. Ranging from 0 (the worst) to 1 (the best), the average quality score for the PHC system was 0.718, with 0.887 for comprehensiveness, 0.781 for accessibility, 0.489 for continuity, and 0.714 for coordination. For clinical care, average quality was 0.773 for disease assessment, 0.768 for diagnosis, 0.677 for treatment, 0.777 for disease management, and 0.314 for provider competence. The average quality for user experience was 0.727, with 0.933 for information sharing, 0.657 for shared decision-making, 0.936 for respect for patients' preferences, and 0.382 for family-centeredness. The differences in quality among population subgroups, although statistically significant, were small.
conclusionThe PHC quality in rural China has shown strengths and limitations. We identified large gaps in continuity of care, treatment, provider competence, family-centeredness, and shared decision-making. Policymakers should invest more effort in addressing these gaps to improve PHC quality.
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