ArticleRisk management and healthcare policy2025
The Ecology of Medical Care in Shanghai: Temporal Trends and International Comparisons.
Article in Risk management and healthcare policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Healthcare-Seeking Behaviors in a Depopulated Rural Area of Shiga Prefecture, Japan in 2025: A Descriptive Study Using the Ecology of Medical Care Model.Journal of general and family medicine · 2026Article
- Determinants Shaping Healthcare Experiences Among Vulnerable Populations in Hong Kong: A Qualitative Descriptive Study.Journal of primary care & community healthArticle
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Authors and funding
4 authors.
Funding
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Abstract
Background: To better understand the temporal evolution of healthcare utilization in Shanghai, this study examines changes in Shanghai's ecology of medical care from 2018 to 2023 and compares them with other countries to contextualize global trends. Methods: Using data from the 7th Shanghai Health Service Survey (2023), this study estimated monthly health-related symptoms and healthcare-seeking behaviors per 1,000 residents, examined subgroup differences via logistic regression, and contextualized findings through a scoping review of international studies applying the ecology of medical care framework. Results: In 2023, per 1,000 Shanghai residents per month, 503 reported illness, 495 sought treatments (including healthcare visits or self-medication), 228 visited healthcare facilities, 144 visited primary care, 98 self-medicated, 31 used TCM, 6 were hospitalized, and 3 underwent surgery. Compared to 2018, self-reported illness (+59), treatment seeking (+62), and self-medication (+6) increased, while outpatient visits, primary care, TCM use, and hospitalizations declined. Internationally, Shanghai shows relatively low illness reporting, primary care use, TCM use, and hospitalization rates, but relatively high treatment-seeking and self-medication. Conclusion: These findings suggest a shift in Shanghai's healthcare utilization from formal services toward individual-led actions, with increased treatment-seeking, higher self-medication, and decreased outpatient, primary care, TCM, and hospitalization use. Internationally, Shanghai shows a distinctive pattern of high treatment-seeking and self-care despite low formal service use, indicating greater reliance on informal health strategies.
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