Quality of primary health care in China: challenges and recommendations

China has substantially increased financial investment and introduced favourable policies for strengthening its primary health care system with core responsibilities in preventing and managing chronic diseases such as hypertension and emerging infectious diseases such as coronavirus disease 2019 (CO...

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Vydáno v:The Lancet (British edition) Ročník 395; číslo 10239; s. 1802 - 1812
Hlavní autoři: Li, Xi, Krumholz, Harlan M, Yip, Winnie, Cheng, Kar Keung, De Maeseneer, Jan, Meng, Qingyue, Mossialos, Elias, Li, Chuang, Lu, Jiapeng, Su, Meng, Zhang, Qiuli, Xu, Dong Roman, Li, Liming, Normand, Sharon-Lise T, Peto, Richard, Li, Jing, Wang, Zengwu, Yan, Hongbing, Gao, Runlin, Chunharas, Somsak, Gao, Xin, Guerra, Raniero, Ji, Huijie, Ke, Yang, Pan, Zhigang, Wu, Xianping, Xiao, Shuiyuan, Xie, Xinying, Zhang, Yujuan, Zhu, Jun, Zhu, Shanzhu, Hu, Shengshou
Médium: Journal Article
Jazyk:angličtina
Vydáno: England Elsevier Ltd 06.06.2020
Elsevier Limited
Témata:
China
Chronic illnesses
Continuity of care
Continuity of Patient Care
Coronavirus Infections
Coronaviruses
COVID-19
Digital data
Fee-for-Service Plans
Health care
Health care policy
Health services
Humans
Hypertension
Infectious diseases
Modernization
Pandemics
Payment systems
Physicians
Physicians, Primary Care - education
Physicians, Primary Care - standards
Pneumonia, Viral
Primary Health Care - organization & administration
Primary Health Care - standards
Public health
Quality of Health Care
Review
Strengthening
Training
Viral diseases
China
ISSN:0140-6736, 1474-547X, 1474-547X
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Shrnutí:China has substantially increased financial investment and introduced favourable policies for strengthening its primary health care system with core responsibilities in preventing and managing chronic diseases such as hypertension and emerging infectious diseases such as coronavirus disease 2019 (COVID-19). However, widespread gaps in the quality of primary health care still exist. In this Review, we aim to identify the causes for this poor quality, and provide policy recommendations. System challenges include: the suboptimal education and training of primary health-care practitioners, a fee-for-service payment system that incentivises testing and treatments over prevention, fragmentation of clinical care and public health service, and insufficient continuity of care throughout the entire health-care system. The following recommendations merit consideration: (1) enhancement of the quality of training for primary health-care physicians, (2) establishment of performance accountability to incentivise high-quality and high-value care; (3) integration of clinical care with the basic public health services, and (4) strengthening of the coordination between primary health-care institutions and hospitals. Additionally, China should consider modernising its primary health-care system through the establishment of a learning health system built on digital data and innovative technologies.
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Contributed equally
ISSN:0140-6736
1474-547X
1474-547X
DOI:10.1016/S0140-6736(20)30122-7