Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Focus on vulnerable populations and promoting equity in health service utilization ––an analysis of visitor characteristics and service utilization of the Chinese community health service

Authors: Xiaoxin Dong, Ling Liu, Shiyi Cao, Huajie Yang, Fujian Song, Chen Yang, Yanhong Gong, Yunxia Wang, Xiaoxu Yin, Xing Xu, Jun Xie, Yi Sun, Zuxun Lu

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents.

Methods

Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors.

Results

The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs.

Conclusions

The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened.
Appendix
Available only for authorised users
Literature
1.
Hall JJ, Taylor R: Health for all beyond 2000: the demise of the Alma-Ata Declaration and primary health care in developing countries. Med J Aust. 2003, 178 (1): 17-20.PubMed
2.
De Maeseneer J, Hjortdahl P, Starfield B: Fix what’s wrong, not what’s right, with general practice in Britain: It has provided better health than government spending deserves. BMJ. 2000, 320 (7250): 1616-10.1136/bmj.320.7250.1616.CrossRefPubMedPubMedCentral
3.
Dahrouge S, Hogg W, Tuna M, Russell G, Devlin RA, Tugwell P, Kristjansson E: Age equity in different models of primary care practice in Ontario. Can Fam Physician. 2011, 57 (11): 1300-1309.PubMedPubMedCentral
4.
Nteta TP, Mokgatle-Nthabu M, Oguntibeju OO: Utilization of the primary health care services in the Tshwane Region of Gauteng Province, South Africa. PloS one. 2010, 5 (11): e13909-10.1371/journal.pone.0013909.CrossRefPubMedPubMedCentral
5.
Xu J, Wang W, Li Y, Zhang J, Pavlova M, Liu H, Yin P, Lu Z: Analysis of factors influencing the outpatient workload at Chinese health centres. BMC Health Serv Res. 2010, 10 (1): 151-10.1186/1472-6963-10-151.CrossRefPubMedPubMedCentral
6.
Williams A, Cookson R: Equity in health. Handb Health Econ. 2000, 1: 1863-1910.CrossRef
7.
Marmot M, Friel S, Bell R, Houweling TA, Taylor S: Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008, 372 (9650): 1661-10.1016/S0140-6736(08)61690-6.CrossRefPubMed
8.
Flaskerud JH, Winslow BJ: Conceptualizing vulnerable populations health-related research. Nurs Res. 1998, 47 (2): 69-10.1097/00006199-199803000-00005.CrossRefPubMed
9.
10.
Li Y, Xu J, Wang F, Wang B, Liu L, Hou W, Fan H, Tong Y, Zhang J, Lu Z: Overprescribing in China, driven by financial incentives, results in very high use of antibiotics, injections, and corticosteroids. Health Aff. 2012, 31 (5): 1075-1082. 10.1377/hlthaff.2010.0965.CrossRef
11.
Dib HH, Sun P, Minmin Z, Wei S, Li L: Evaluating community health centers in the City of Dalian, China: how satisfied are patients with the medical services provided and their health professionals?. Health Place. 2010, 16 (3): 477-488. 10.1016/j.healthplace.2009.12.005.CrossRefPubMed
12.
Li X, Zhang T: The comparative analysis of the basic characteristics of the outpatients of the community health service institutions in a city. Chinese Health Quality Management. 2008, 15 (6): 81-83.
13.
Ren X, Li N, Gao B, Zhang W, Liu D: The analysis of the diseases of the community health service centers in Chengdu city. Chinese General Practice. 2006, 9 (17): 1472-1473.
14.
Yang C, Zheng Y, Zhai H: The situation of the medical services of the national community health service sites. Chinese General Practice. 2009, 7 (6): 633-635.
15.
The Statistic Center of PR China Ministry of Health: An Analysis Report of National Health Services Survey in China, 2008. 2009, Beijing: Pekin Union Medical College Press
16.
17.
Scott AJ: World Development Report 2009: reshaping economic geography. J Econ Geogr. 2009, 9 (4): 583-586. 10.1093/jeg/lbp019.CrossRef
18.
19.
Lu Z, Li Y, Wang F, Wang B, Liu L, Zhou W, Qin G: The Development, effect and concerned issues of pilot work of National Community Health Service System Building in key contact cities–based on the Comprehensive Analysis of the Baseline Survey and Routine Monitoring Data. Chinese J Soc Med. 2009, 26 (006): 321-325.
20.
Mo J: The poverty and social security of Hong Kong. 1993, Hong Kong: Zhong Hua Book Company
21.
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA: Gender differences in the utilization of health care services. J Fam Pract. 2000, 49 (2): 147-152.PubMed
22.
Parslow R, Jorm A, Christensen H, Jacomb P, Rodgers B: Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians. Soc Sci Med (1982). 2004, 59 (10): 2121-10.1016/j.socscimed.2004.03.018.CrossRef
23.
Margolis SA, Al-Marzouqi S, Revel T, Reed RL: Patient satisfaction with primary health care services in the United Arab Emirates. Int J Qual Health Care. 2003, 15 (3): 241-249. 10.1093/intqhc/mzg036.CrossRefPubMed
24.
Mash B, Fairall L, Adejayan O, Ikpefan O, Kumari J, Mathee S, Okun R, Yogolelo W: A morbidity survey of South African primary care. PLoS One. 2012, 7 (3): e32358-10.1371/journal.pone.0032358.CrossRefPubMedPubMedCentral
25.
Cui M, Yin D, Jin C, Chen X, Wang L, Yang H, Wu Q, Wang B, He S, Xu Z, Cao B, Chen B: Study on the ability of child health services in primary health institutions. Chinese J Child Health Care. 2012, 20 (10): 872-874.
26.
Zhou Y, Qian D, Xu L, Zhang Y: Analysis on the trend of change of outpatients’ characteristics in urban community health institutions. Chinese Health Resources. 2011, 14 (4): 259-261.
27.
Duan X, Qin Z: The analysis of the implementation situation of the basic public health services project in city. Chinese J Pub Health. 1999, 16 (2): 72-75.
28.
Dunlop S, Coyte PC, McIsaac W: Socio-economic status and the utilization of physicians’ services: results from the Canadian National Population Health Survey. Soc Sci Med. 2000, 51 (1): 123-10.1016/S0277-9536(99)00424-4.CrossRefPubMed
29.
Xu S, Xiong G, Zhao J: The analysis of the flow and the cost of the outpatient covered by medical insurance. Chinese J Soc Med. 2011, 28 (2): 131-132.
30.
Mills A, Brugha R, Hanson K, McPake B: What can be done about the private health sector in low-income countries?. Bull World Health Organ. 2002, 80 (4): 325-330.PubMedPubMedCentral
31.
Shen T, Cheng H, Chen Z, Shi R: The survey of the utilization of the community health service and the analysis of the factors of the residents in Shanghai. J Shanghai Jiaotong University (Medical Science). 2010, 1 (30): 944-963.
32.
33.
Liu Y, Li T, Xia J, Wang F, Lu Z: The Responsibility of Government in Finance of Community Health Service. Chinese J Soc Med. 2008, 24 (4): 224-226.
34.
Liu Y, Li T, Zou J, Huang X, Lu Z: Increasing the fund investment to promote the sustainable development of community health service. Chinese Health Economics. 2007, 26 (9): 34-34.
35.
Okkes I, Polderman G, Fryer G, Yamada T, Bujak M, Oskam S: The role of family practice in different health care systems. J Fam Pract. 2002, 51: 72-73.PubMed
36.
Villani J, Mortensen K: Patient-provider communication and timely receipt of preventive services. Prev Med. 2013, 57 (5): 658-663. 10.1016/j.ypmed.2013.08.034.CrossRefPubMed
37.
Gowin E, Avonts D, Horst-Sikorska W, Ignaszak-Szczepaniak M, Michalak M: Gender makes the difference: the influence of patients’ gender on the delivery of preventive services in primary care in Poland. Qual Prim Care. 2009, 17 (5): 343-350.PubMed
38.
Macinko J, Starfield B, Shi L: The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970–1998. Health Serv Res. 2003, 38 (3): 831-865. 10.1111/1475-6773.00149.CrossRefPubMedPubMedCentral
39.
Qin J, Qin Z: The reward mechanism of the income of the British general practitioners. Foreign Med. 1999, 16 (2): 72-75.
40.
Bernabei R, Landi F, Gambassi G, Sgadari A, Zuccala G, Mor V, Rubenstein LZ, Carbonin P: Randomized trial of impact of model of integrated care and case management for older people living in the community. BMJ. 1998, 316 (7141): 1348-10.1136/bmj.316.7141.1348.CrossRefPubMedPubMedCentral
41.
Miller KW, Wilder LB, Stillman FA, Becker DM: The feasibility of a street-intercept survey method in an African-American community. Am J Pub Health. 1997, 87 (4): 655-658. 10.2105/AJPH.87.4.655.CrossRef
Metadata
Title
Focus on vulnerable populations and promoting equity in health service utilization ––an analysis of visitor characteristics and service utilization of the Chinese community health service
Authors
Xiaoxin Dong
Ling Liu
Shiyi Cao
Huajie Yang
Fujian Song
Chen Yang
Yanhong Gong
Yunxia Wang
Xiaoxu Yin
Xing Xu
Jun Xie
Yi Sun
Zuxun Lu
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-503

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue

Research article

A Markov chain model for studying suicide dynamics: an illustration of the Rose theorem

Study protocol

Preventing substance misuse: study protocol for a randomised controlled trial of the Strengthening Families Programme 10–14 UK (SFP 10–14 UK)

Research article

Residential characteristics as correlates of occupants’ health in the greater Accra region, Ghana

Research article

The accessibility and acceptability of self-management support interventions for men with long term conditions: a systematic review and meta-synthesis of qualitative studies

Research article

Design of non-pharmaceutical intervention strategies for pandemic influenza outbreaks

Research article

Offending, custody and opioid substitution therapy treatment utilisation among opioid-dependent people in contact with the criminal justice system: comparison of Indigenous and non-Indigenous Australians