Zhan Kexin, Wan Chuchuan, Wang Ennan, Huang Yuankai
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China.
The Research Center of National Drug Policy & Ecosystem, Pharmaceutical University, Nanjing, Jiangsu, China.
Arch Public Health. 2025 Jun 23;83(1):166. doi: 10.1186/s13690-025-01663-8.
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.
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.
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 = 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.
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.
本研究旨在评估中国基层医疗卫生机构（PHIs）的基层医疗服务质量现状，并分析可能影响基层医疗服务质量的潜在因素。
本研究采用便利抽样法，运用中国基层医疗评估工具（PCAT-C）收集全国基层医疗卫生机构就诊患者基层医疗服务体验的横断面数据。建立多元线性回归模型，探讨各因素对基层医疗卫生机构基层医疗服务质量的影响。
本研究共纳入2063例有效病例，PCAT总评分为71.31（标准差=11）。在不同维度中，综合性维度平均得分最高，为77.78±15.83，其次是连续性（75.81±10.68）、家庭为中心（75.67±17.69）、首诊（69.46±10.36）、协调性（69.39±16.84），社区导向维度平均得分最低，为59.75±16.93。回归分析（R=0.0437，p<0.000）表明，患者所在地区（东部、中部或西部）（p<0.001）、区域（城市或农村）（p=0.026）、是否有成年子女（p=0.008）、工作状态（p=0.003）、家庭年收入（p=0.007）、是否参加商业医疗保险（p=0.001）、是否因病就医（p=0.014）、每万人口医院床位数（p=0.007）以及人均卫生支出占人均GDP的百分比（p=0.021）对基层医疗卫生机构的基层医疗服务质量有显著影响。
中国基层医疗卫生机构的基层医疗服务质量仍较低，受到微观和宏观因素的影响。中国基层医疗卫生机构的基层医疗服务质量仍相对较低，尤其是在社区导向维度。基层医疗卫生机构的基层医疗服务质量除受微观因素影响外，还受到卫生总支出和经济状况等宏观因素的影响。建议努力提高医疗卫生资源配置机制的公平性，促进区域均衡发展。
