Abstract
Background: Primary health care (PHC) is a key component of the health care system in many countries. In China, however, PHC institutions are less preferred by patients, leading to the underuse of PHC services. Factors affecting patients' preferences for PHC institutions in China remain unreported in the current literature, which was first explored in this study.Method: A qualitative interview study was conducted in Nanjing, Jiangsu Province of China. A semi-structured interview guide was applied to ask patients' opinions regarding the PHC institutions in China. Qualitative data analysis was conducted using the thematic framework approach.Results: A total of 142 participants were interviewed. Three themes and their sub-themes emerged from the study: (1) attributes of PHC services, including accessibility of primary healthcare services, consultation time, drug cost, continuity of care, referral system, opening hours, waiting time, and drug accessibility; (2) attributes of PHC doctors' workforce, including doctors' attitude, competence, and accessibility; (3) attributes of PHC facility infrastructure, including basic facilities, diagnostic facilities and department settings. It was identified that some attributes of PHC services had positive impacts on participants' preferences for PHC institutions, while the same attributes of PHC doctors were the opposite.Conclusion: There are three major factors that contribute to patients' preferences for PHC institutions in China. Policy interventions to improve doctors' workforce and facility infrastructure of PHC institutions are needed to promote patients' preferences for PHC.
Highlights
Primary health care (PHC) is the essential health care universally accessible to individuals and families in the community, and PHC services are affordable to the community and the country through the full participation of healthcare providers based on practical, scientifically sound and socially acceptable methods and technologies [1]
The government has issued a series of policies on the re-construction and development of PHC system to enhance the provision of PHC services, such as increasing the government’s investment, expanding the coverage of the universal health insurance, implementing the national basic public health service program, etc
It is a triage system based on close collaboration among health care institutions of different levels intended to achieve the optimal outcome by elaborating on their roles and functions in the health care system [5]
Summary
Primary health care (PHC) is the essential health care universally accessible to individuals and families in the community, and PHC services are affordable to the community and the country through the full participation of healthcare providers based on practical, scientifically sound and socially acceptable methods and technologies [1]. Factors of Preferences for Primary Health Care system as well as the first-contact between individuals and the health system [2], which provides various types of medical services, such as the diagnosis and treatment of chronic diseases, the health education, etc By performing those services, PHCs cover most health problems of the residents at the scale of community. One of the main strategies is the establishment of the National Hierarchical Medical System (NHMS) It is a triage system based on close collaboration among health care institutions of different levels intended to achieve the optimal outcome by elaborating on their roles and functions in the health care system [5]. Factors affecting patients’ preferences for PHC institutions in China remain unreported in the current literature, which was first explored in this study
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