PT  - JOURNAL ARTICLE
AU  - Wong, William C. W.
AU  - Jiang, Sunfang
AU  - Ong, Jason J.
AU  - Peng, Minghui
AU  - Wan, Eric
AU  - Zhu, Shanzhu
AU  - Lam, Cindy L. K.
AU  - Kidd, Michael R.
AU  - Roland, Martin
TI  - Bridging the Gaps Between Patients and Primary Care in China: A Nationwide Representative Survey
AID  - 10.1370/afm.2034
DP  - 2017 May 01
TA  - The Annals of Family Medicine
PG  - 237--245
VI  - 15
IP  - 3
4099  - http://www.annfammed.org/content/15/3/237.short
4100  - http://www.annfammed.org/content/15/3/237.full
SO  - Ann Fam Med2017 May 01; 15
AB  - PURPOSE China introduced a national policy of developing primary care in 2009, establishing 8,669 community health centers (CHCs) by 2014 that employed more than 300,000 staff. These facilities have been underused, however, because of public mistrust of physicians and overreliance on specialist care.METHODS We selected a stratified random sample of CHCs throughout China based on geographic distribution and urban-suburban ratios between September and December 2015. Two questionnaires, 1 for lead clinicians and 1 for primary care practitioners (PCPs), asked about the demographics of the clinic and its clinical and educational activities. Responses were obtained from 158 lead clinicians in CHCs and 3,580 PCPs (response rates of 84% and 86%, respectively).RESULTS CHCs employed a median of 8 physicians and 13 nurses, but only one-half of physicians were registered as PCPs, and few nurses had training specifically for primary care. Although virtually all clinics were equipped with stethoscopes (98%) and sphygmomanometers (97%), only 43% had ophthalmoscopes and 64% had facilities for gynecologic examination. Clinical care was selectively skewed toward certain chronic diseases. Physicians saw a median of 12.5 patients per day. Multivariate analysis showed that more patients were seen daily by physicians in CHCs organized by private hospitals and those having pharmacists and nurses.CONCLUSIONS Our survey confirms China’s success in establishing a large, mostly young primary care workforce and providing ongoing professional training. Facilities are basic, however, with few clinics providing the comprehensive primary care required for a wide range of common physical and mental conditions. Use of CHCs by patients remains low.