Enhancing primary healthcare capacity : A qualitative study from the perspective of managers of PHC institutions in China

Context: Community health services constitute the cornerstone of China's primary healthcare system. Since the recent healthcare reforms, significant strides have been made in the development of community health services across the country. However, facing the challenges brought by China's national health strategy, aging population, and high incidence of chronic diseases, there is an urgent need to improve the service capacity of China's primary medical institutions.

Objective: The aim of this study is to explore how to enhance primary healthcare capacity in China from the perspective of managers of primary health care institutions.

Study Design: A qualitative study

Setting: Primary care setting in Shanghai, China Population Studied, 15 directors of the high-quality development pilot community health service centers in Shanghai were selected as interviewees.

Instrument: A semi-structured interview

Outcome Measures: Framework of Primary Care Measurement Domains and Key Elements proposed by Starfield III Conference is used as the analytical framework for this study.

Results: Four main categories of enhancement elements were identified: 1) Receipt of Care; 2) Provision of Care; 3)Outcomes of Care; 4) Ecology of Care. Patients can perceive the following three characteristics of the services provided by community health service centers: services with high quality, integrated services, and services with “speed”, and “warmth”, which helps to improve their evaluation of the medical service quality and capability of such institutions. In the analysis of data related to the provision of basic medical services, two main categories are highlighted: the scope of basic medical services and the key target populations. The outcomes suitable for evaluating the primary healthcare capabilities mainly focus on three aspects that are more important to residents, institutions, and government health management. The ecological environment of primary healthcare can be divided into three categories: health policies, the institution's endogenous resources, and exogenous resources.

Conclusions: The enhancement of primary healthcare capabilities should be centered around the clinical medical services for common, frequent, and chronic diseases that revolve around the needs of residents. There should be an innovative integration of service models and technologies that deliver high-quality performance in terms of medical quality, efficiency, and effectiveness.