{"title":"中国基层卫生保健机构初级保健质量现状及影响因素","authors":"Kexin Zhan, Chuchuan Wan, Ennan Wang, Yuankai Huang","doi":"10.1186/s13690-025-01663-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the current state of primary care quality within Primary Healthcare Institutions (PHIs) in China and analyze potential factors that may influence the quality of primary care provided.</p><p><strong>Methods: </strong>Employing convenience sampling, this research utilized the Chinese Primary Care Assessment Tool (PCAT-C) to gather cross-sectional data on patients' experiences with primary care during visits to PHIs across the country. A multivariate linear regression model was established to discuss the effects of various factors on the quality of primary care at PHIs.</p><p><strong>Results: </strong>The study encompassed 2,063 valid cases, with an overall PCAT score of 71.31 (SD = 11). Among the different dimensions, the average score for the Comprehensiveness dimension was the highest at 77.78 ± 15.83, followed by Continuity (75.81 ± 10.68), Family-centered (75.67 ± 17.69), First Contact (69.46 ± 10.36), Coordination (69.39 ± 16.84), and the Community-orientation dimension with the lowest average score at 59.75 ± 16.93. The regression analysis (R<sup>2</sup> = 0.0437, p < 0.000) indicated that the patient's area(Eastern, Middle or Western) (p < 0.001), region(Urban or Rural)(p = 0.026), presence of adult children (p = 0.008), working status (p = 0.003), family annual income (p = 0.007), participation in commercial medical insurance (p = 0.001), seeking medical attention for illness was sought (p = 0.014), the number of hospital beds per 10,000 population (p = 0.007), and per capita health expenditure as a percentage of GDP per capita (p = 0.021) significantly impact the quality of primary care at PHIs.</p><p><strong>Conclusion: </strong>The quality of primary care for PHIs in China is still low and is affected by both micro and macro factors. The quality of primary care at PHIs in China is still relatively low, particularly in the Community-orientation dimension. Apart from being influenced by microscopic factors, the quality of primary care at PHIs is also affected by macro factors such as overall health expenditure and economic status. It is recommended that efforts be made to enhance the equity of the medical and health resource allocation mechanism, thereby promoting balanced regional development.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"166"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183844/pdf/","citationCount":"0","resultStr":"{\"title\":\"Primary care quality of primary healthcare institutions in china: current status and influencing factors.\",\"authors\":\"Kexin Zhan, Chuchuan Wan, Ennan Wang, Yuankai Huang\",\"doi\":\"10.1186/s13690-025-01663-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to assess the current state of primary care quality within Primary Healthcare Institutions (PHIs) in China and analyze potential factors that may influence the quality of primary care provided.</p><p><strong>Methods: </strong>Employing convenience sampling, this research utilized the Chinese Primary Care Assessment Tool (PCAT-C) to gather cross-sectional data on patients' experiences with primary care during visits to PHIs across the country. A multivariate linear regression model was established to discuss the effects of various factors on the quality of primary care at PHIs.</p><p><strong>Results: </strong>The study encompassed 2,063 valid cases, with an overall PCAT score of 71.31 (SD = 11). Among the different dimensions, the average score for the Comprehensiveness dimension was the highest at 77.78 ± 15.83, followed by Continuity (75.81 ± 10.68), Family-centered (75.67 ± 17.69), First Contact (69.46 ± 10.36), Coordination (69.39 ± 16.84), and the Community-orientation dimension with the lowest average score at 59.75 ± 16.93. The regression analysis (R<sup>2</sup> = 0.0437, p < 0.000) indicated that the patient's area(Eastern, Middle or Western) (p < 0.001), region(Urban or Rural)(p = 0.026), presence of adult children (p = 0.008), working status (p = 0.003), family annual income (p = 0.007), participation in commercial medical insurance (p = 0.001), seeking medical attention for illness was sought (p = 0.014), the number of hospital beds per 10,000 population (p = 0.007), and per capita health expenditure as a percentage of GDP per capita (p = 0.021) significantly impact the quality of primary care at PHIs.</p><p><strong>Conclusion: </strong>The quality of primary care for PHIs in China is still low and is affected by both micro and macro factors. The quality of primary care at PHIs in China is still relatively low, particularly in the Community-orientation dimension. Apart from being influenced by microscopic factors, the quality of primary care at PHIs is also affected by macro factors such as overall health expenditure and economic status. It is recommended that efforts be made to enhance the equity of the medical and health resource allocation mechanism, thereby promoting balanced regional development.</p>\",\"PeriodicalId\":48578,\"journal\":{\"name\":\"Archives of Public Health\",\"volume\":\"83 1\",\"pages\":\"166\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183844/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Public Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13690-025-01663-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13690-025-01663-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Primary care quality of primary healthcare institutions in china: current status and influencing factors.
Objective: This study aims to assess the current state of primary care quality within Primary Healthcare Institutions (PHIs) in China and analyze potential factors that may influence the quality of primary care provided.
Methods: Employing convenience sampling, this research utilized the Chinese Primary Care Assessment Tool (PCAT-C) to gather cross-sectional data on patients' experiences with primary care during visits to PHIs across the country. A multivariate linear regression model was established to discuss the effects of various factors on the quality of primary care at PHIs.
Results: The study encompassed 2,063 valid cases, with an overall PCAT score of 71.31 (SD = 11). Among the different dimensions, the average score for the Comprehensiveness dimension was the highest at 77.78 ± 15.83, followed by Continuity (75.81 ± 10.68), Family-centered (75.67 ± 17.69), First Contact (69.46 ± 10.36), Coordination (69.39 ± 16.84), and the Community-orientation dimension with the lowest average score at 59.75 ± 16.93. The regression analysis (R2 = 0.0437, p < 0.000) indicated that the patient's area(Eastern, Middle or Western) (p < 0.001), region(Urban or Rural)(p = 0.026), presence of adult children (p = 0.008), working status (p = 0.003), family annual income (p = 0.007), participation in commercial medical insurance (p = 0.001), seeking medical attention for illness was sought (p = 0.014), the number of hospital beds per 10,000 population (p = 0.007), and per capita health expenditure as a percentage of GDP per capita (p = 0.021) significantly impact the quality of primary care at PHIs.
Conclusion: The quality of primary care for PHIs in China is still low and is affected by both micro and macro factors. The quality of primary care at PHIs in China is still relatively low, particularly in the Community-orientation dimension. Apart from being influenced by microscopic factors, the quality of primary care at PHIs is also affected by macro factors such as overall health expenditure and economic status. It is recommended that efforts be made to enhance the equity of the medical and health resource allocation mechanism, thereby promoting balanced regional development.
期刊介绍:
rchives of Public Health is a broad scope public health journal, dedicated to publishing all sound science in the field of public health. The journal aims to better the understanding of the health of populations. The journal contributes to public health knowledge, enhances the interaction between research, policy and practice and stimulates public health monitoring and indicator development. The journal considers submissions on health outcomes and their determinants, with clear statements about the public health and policy implications. Archives of Public Health welcomes methodological papers (e.g., on study design and bias), papers on health services research, health economics, community interventions, and epidemiological studies dealing with international comparisons, the determinants of inequality in health, and the environmental, behavioural, social, demographic and occupational correlates of health and diseases.