Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China.
School of Social and Behavioral Sciences, Nanjing University, Nanjing, China.
Int J Health Plann Manage. 2019 Oct;34(4):e1609-e1620. doi: 10.1002/hpm.2854. Epub 2019 Jul 18.
The primary care reform developed in Xiamen City stood out among the dozens of pilot reforms conducted in China. The aim of this study was to investigate the effects of the reform.
The data were collected from the Annual Statistical Report on Xiamen's Hospitals and face-to-face questionnaire interviews among physicians (n = 107) and community members (n = 399). Binary logistic regression was performed to analyze the factors influencing the community members' preference for treatment in community health centers (CHCs).
The drug cost declined nearly 3.0% in hospitals, and outpatient visits increased more quickly (27.1%) in CHCs. A total of 86.2% of community members preferred to receive treatment for slight illness or chronic diseases in CHCs, and 77.9% of them were willing to be referred to CHCs during the recovery period. Patients who were managed by the general practice (GP) team showed higher percentages in examining and controlling blood pressure and blood glucose.
The reform in Xiamen was easily accepted by physicians and community members. The reform had rendered initial achievements in reducing drug income in hospitals, increasing outpatient visits in CHCs, seeking health care in CHCs, and controlling blood pressure and glucose for patients with chronic diseases.
厦门市开展的基层医疗改革在全国数十项试点改革中脱颖而出。本研究旨在调查改革的效果。
数据来自厦门市医院年度统计报告以及对医生（n=107）和社区居民（n=399）的面对面问卷调查。采用二元逻辑回归分析影响社区居民选择在社区卫生服务中心（CHC）就诊的因素。
医院的药品费用下降了近 3.0%，而 CHC 的门诊量增长更快（27.1%）。共有 86.2%的社区居民愿意在 CHC 治疗轻微疾病或慢性病，77.9%的人愿意在康复期间转至 CHC。由全科医生（GP）团队管理的患者在检查和控制血压和血糖方面的比例更高。
厦门市的改革得到了医生和社区居民的认可。改革在降低医院药品收入、增加 CHC 门诊量、在 CHC 寻求医疗服务以及控制慢性病患者的血压和血糖方面取得了初步成效。
