Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China.
Business Department Center of Red Cross Society of China, Beijing, China.
Hong Kong Med J. 2022 Aug;28(4):306-314. doi: 10.12809/hkmj209153. Epub 2022 Aug 8.
Primary healthcare in rural China is underutilised, especially in village clinics in Southwest China. The aim of this study was to explore any relationships among the ethnicity of the healthcare provider, the clinical competence of the healthcare provider, and the utilisation of village clinics in Southwest China.
This cross-sectional survey study involved 330 village healthcare providers from three prefectures in Yunnan Province in 2017. Multiple logistic regressions were adopted to investigate the utilisation of primary healthcare among different ethnic healthcare providers.
Primary healthcare utilisation was higher in village clinics where healthcare providers were Han Chinese than those where healthcare providers were ethnic minority (151 vs 101, P=0.008). The logistic regression analysis showed that clinical competence was positively associated with the utilisation of primary healthcare (odds ratio [OR]=1.49, 95% confidence interval [CI]=1.12-2.00; P=0.007) and that inadequate clinical competence of ethnic minority health workers may lead to a lag in the utilisation of primary healthcare (OR=0.45, 95% CI=0.23-0.89; P=0.022).
Our results confirm differences in the utilisation of primary healthcare in rural Yunnan Province among healthcare providers of different ethnicities. Appropriate enhancements of clinical competence could be conducive to improving the utilisation of primary healthcare, especially among ethnic minority healthcare providers.
中国农村的初级卫生保健服务利用率较低，尤其是在中国西南地区的乡村诊所。本研究旨在探讨医疗服务提供者的族裔、临床能力与中国西南地区乡村诊所利用率之间的关系。
本横断面调查研究于 2017 年纳入了云南省三个州的 330 名乡村卫生保健提供者。采用多变量逻辑回归分析不同族裔卫生保健提供者之间的初级卫生保健利用情况。
汉族医疗服务提供者所在的乡村诊所的初级卫生保健利用率高于少数民族医疗服务提供者所在的乡村诊所（151 比 101，P=0.008）。逻辑回归分析表明，临床能力与初级卫生保健的利用呈正相关（比值比[OR]=1.49，95%置信区间[CI]=1.12-2.00；P=0.007），少数民族卫生工作者临床能力不足可能导致初级卫生保健利用率滞后（OR=0.45，95%CI=0.23-0.89；P=0.022）。
我们的研究结果证实了云南省农村地区不同族裔医疗服务提供者之间初级卫生保健服务利用率存在差异。适当提高临床能力有助于提高初级卫生保健的利用率，特别是在少数民族医疗服务提供者中。
