Xiaolin Wei1, Nan Yang2, Yang Gao3, Samuel Y S Wong4, Martin C S Wong5, Jiaji Wang6, Harry H X Wang7, Donald K T Li8, Jinling Tang9, Sian M Griffiths10. 1. Assistant Professor, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China Assistant Professor, Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong, China xiaolinwei@cuhk.edu.hk. 2. Research Assistant, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China. 3. Assistant Professor, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China Assistant Professor, Department of Physical Education, the Hong Kong Baptist University, China. 4. Professor, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China. 5. Associate Professor, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China. 6. Professor, School of Public Health, Guangzhou Medical University, China. 7. Lecturer, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China. 8. Chair, Bauhinia Foundation Research Centre, China. 9. Associate Professor, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China Professor, Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong, China. 10. Professor Emeritus, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China.
Abstract
OBJECTIVES: Community health centres are the main form of provision of primary care in China. There are three models: government managed, hospital managed and private. Our aim was to describe and compare primary care under the three ownership models. METHODS: Four aspects of primary care were studied: services, organization, financing and human resources. Interviews were undertaken with 60 managerial and professional staff in 13 community health centres in the Pearl River Delta region in 2010. Three community health centres were selected in the capital city and two were selected from each of the other five cities. Thematic framework analysis was conducted. RESULTS: Government-managed community health centres received the largest public funding, followed by hospital-managed community health centres, while private community health centres received the least. Private community health centres were the smallest in scale and provided lower quality public health services compared with the other two models. Patient out-of-pocket costs accounted for the majority of the revenue in all models of community health centres despite improved government funding for preventive services. General challenges such as the shortage of public funding, the exclusion of migrants in the funding for preventive services, low capacity in human resources and the separation of clinical and preventive care in community health centres were identified in all three models of community health centres. CONCLUSIONS: The ownership and management of a community health centre greatly influence the service it provides. Private community health centres are in a disadvantaged position to deliver high quality clinical and preventive care.
OBJECTIVES: Community health centres are the main form of provision of primary care in China. There are three models: government managed, hospital managed and private. Our aim was to describe and compare primary care under the three ownership models. METHODS: Four aspects of primary care were studied: services, organization, financing and human resources. Interviews were undertaken with 60 managerial and professional staff in 13 community health centres in the Pearl River Delta region in 2010. Three community health centres were selected in the capital city and two were selected from each of the other five cities. Thematic framework analysis was conducted. RESULTS: Government-managed community health centres received the largest public funding, followed by hospital-managed community health centres, while private community health centres received the least. Private community health centres were the smallest in scale and provided lower quality public health services compared with the other two models. Patient out-of-pocket costs accounted for the majority of the revenue in all models of community health centres despite improved government funding for preventive services. General challenges such as the shortage of public funding, the exclusion of migrants in the funding for preventive services, low capacity in human resources and the separation of clinical and preventive care in community health centres were identified in all three models of community health centres. CONCLUSIONS: The ownership and management of a community health centre greatly influence the service it provides. Private community health centres are in a disadvantaged position to deliver high quality clinical and preventive care.
Authors: Xiaolin Wei; Jia Yin; Samuel Y S Wong; Sian M Griffiths; Guanyang Zou; Leiyu Shi Journal: Medicine (Baltimore) Date: 2017-01 Impact factor: 1.889
Authors: Blake Angell; Rebecca Dodd; Anna Palagyi; Thomas Gadsden; Seye Abimbola; Shankar Prinja; Stephen Jan; David Peiris Journal: BMJ Glob Health Date: 2019-08-16
Authors: Min Su; Zhongliang Zhou; Yafei Si; Sean Sylvia; Gang Chen; Yanfang Su; Scott Rozelle; Xiaolin Wei Journal: Int J Environ Res Public Health Date: 2021-05-11 Impact factor: 3.390
Authors: Haitao Li; Xiaolin Wei; Martin Chi-Sang Wong; Samuel Yeung-Shan Wong; Nan Yang; Sian M Griffiths Journal: Medicine (Baltimore) Date: 2015-08 Impact factor: 1.817
Authors: Guanyang Zou; Wei Zhang; Rebecca King; Zhitong Zhang; John Walley; Weiwei Gong; Min Yu; Xiaolin Wei Journal: Int J Environ Res Public Health Date: 2020-06-10 Impact factor: 3.390