Comparison of Patients' Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China.

Leiyu Shi,Shanshan Feng,Liang Zhang,Aiyun Chen

doi:10.3390/ijerph17134898

Abstract

Background: A series of reforms were implemented to improve the quality of primary care services in China. This study aims to assess patients’ perceived quality of primary healthcare between rural and urban community health centers in Guangdong. Methods: A cross-sectional survey was conducted from July to December 2015 in Guangdong. We surveyed 1010 respondents who visited either community health centers/stations (CHCs/CHSs) in urban areas or township health centers/rural health stations (THCs/RHSs) in rural areas. A validated Chinese version of the Primary Care Assessment Tool-Adult Short Version (PCAT-AS), representing ten primary care domains, was used to collect information on patients’ primary care experiences. A t-test was used for comparison on domain scores and total scores between patients from CHCs/CHSs and THCs/RHSs. An analysis of covariance was employed to compare the adjusted PCAT domain scores and total scores. Multilevel models were used to explore factors associated with PCAT total scores. Results: Overall, patients reported a lower level of experience of community orientation and family centeredness compared to other primary care domains. Patients from THCs/RHSs settings in the rural area reported better primary care experience in four domains, including first contact, accessibility, ongoing care, and community orientation. Higher education background and those with a chronic disease were associated with better primary care experience, after controlling for confounding factors. Patients who preferred primary care institutions when getting sick or used health services more frequently reported better primary care experiences. Conclusion: Continued efforts are needed to strengthen primary care performances, particularly in a community orientation and family centeredness. Primary care delivery in CHCs/CHSs settings should be improved in four domains, including first contact, accessibility, ongoing care, and community orientation.

Highlights

Achieving universal health coverage is an important health goal for all nations
community health centers (CHCs)/community health stations (CHSs) in urban areas or township health centers (THCs)/rural health stations (RHSs) in rural areas and differed in gender, age, education background, income, self-reported health status, the time it takes to walk to the nearest primary care institution, whether patients used primary care institutions as the first choice when getting sick, and the number of visits to a primary care institution the previous year
THCs/RHSs users were more likely to take less than 30 min walking to the nearest primary care institution and preferred to use THCs/RHSs when getting sick

Summary

Introduction

Achieving universal health coverage is an important health goal for all nations. It means individuals, regardless of gender, economic status, disease status, or healthcare delivery system experienced, should be provided equitable access to basic health services [1]. This study aims to assess patients’ perceived quality of primary healthcare between rural and urban community health centers in Guangdong. We surveyed 1010 respondents who visited either community health centers/stations (CHCs/CHSs) in urban areas or township health centers/rural health stations (THCs/RHSs) in rural areas. A validated Chinese version of the Primary Care Assessment Tool-Adult Short Version (PCAT-AS), representing ten primary care domains, was used to collect information on patients’ primary care experiences. A t-test was used for comparison on domain scores and total scores between patients from CHCs/CHSs and THCs/RHSs

Objectives

Results

Discussion

Conclusion