Effects of Healthcare Policies and Reforms at the Primary Level in China: From the Evidence of Shenzhen Primary Care Reforms from 2018 to 2019.

Mingyue Wen,Liao Liao,Xunzhi Zhou,Yilin Wang

doi:10.3390/ijerph19041945

Abstract

Countries worldwide are making efforts to achieve health equity. China focuses on the implementation of the policy goal of “improving the primary level” to eliminate the health equity gap. The main purpose of this study is to examine the effects of the healthcare reforms at the primary level in China and to analyze the key factors that can help to improve their effectiveness. From the perspectives of the policy attention mechanism and public policy analysis, this study will explore primary care reforms from policy formulation to policy implementation on the basis of grounded theory and empirical research on primary care reforms in Shenzhen, China, that was conducted from 2018 to 2019. The present study found that the government pays close attention to the medical level and service level of primary care services at the policy formulation phase but less attention to talent level and information sharing. At the same time, this study combined with empirical data from primary care centers in Shenzhen for the period covering 2018 to 2019 evaluates policy implementation and its effect. Multiple regression analysis revealed that the medical level, talent level, service level, and information sharing helped to develop primary care services and improved health equity. Nevertheless, this study reflects a deviation between policy formulation and policy implementation for the development of primary care policies. Empirical experience shows that the development of talent level and information sharing can significantly promote primary care services and health management. Therefore, this study implies that in the process of promoting the health equity at the primary level, more attention should be paid to the consistency between policy formulation and policy implementation. Additionally, the policy promotion and influence mechanism can be improved, particularly in terms of talent development and information sharing, in order to effectively promote the development of health equity at the primary level.

Highlights

Introduction iationsReducing health inequality requires action across the whole of society
Many studies have evaluated healthcare policies in China from the perspectives of the supply of medical and healthcare resources, the utilization efficiency, or the resource allocation degree at the regional level and some other studies have examined the main factors influencing the effects of the healthcare policies, such as the number of doctors and therapists, support clinics, and home-visit treatments, little attention has been paid to the interactive process between healthcare policy formulation and implementation and its effects
The results showed that the total number of GPs had a significant positive relationship with the health management level, which is consistent with Hypothesis 1, which confirms that the higher the medical level is, the higher the primary care service effects are

Summary

Introduction

Reducing health inequality requires action across the whole of society. There is a great deal of scientific evidence on health inequalities, health policies require more evaluation, in the countries where public health is fundamental in influencing the health level of society. China Health Commission national grassroots health work conference urged the Chinese government to thoroughly implement a healthcare policy “focusing on grass-roots units”. In China, eliminating health disparity has become a significant policy goal, since the beginning of the COVID-19 pandemic. Against this background, primary healthcare development has been implemented as a strategy to achieve this target in China over the past ten years [1].

Objectives

Results

Conclusion