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Comparison of Primary Care Experiences in Village Clinics with Different Ownership Models in Guangdong Province, China

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  • Shanshan Feng
  • Leiyu Shi
  • Jiazhi Zeng
  • Wen Chen
  • Li Ling

Abstract

Objectives: In order to improve the quality of services at village clinics (VCs), which are important primary care service providers in rural China, the Chinese government has encouraged the township hospitals to own and manage VCs. There are currently three models of ownership and management of VCs: township hospital-owned and -managed (HVC), village committee-owned and -managed (VVC), and private-owned and -managed (PVC). This study aims to examine the association between these ownership models of VCs and patients' primary care experiences. Methods: Villagers were selected by multistage stratified sampling and their experiences with primary care were measured using the Primary Care Assessment Tool—Adult Edition (PCAT-AS). Data were collected through face-to-face interviews and the questionnaires administered by investigators in the cross-sectional study from February to April 2015. The PCAT scores were compared among the three models by covariance analysis, and multiple linear regression was used to analyze factors associated with the PCAT total scores. Results: A total of 1491 questionnaires were collected. After controlling for covariates, HVCs reported the highest PCAT scores and satisfaction rate. In terms of the domains, HVC reported the highest scores in the coordination and comprehensiveness domains, while PVC had the highest scores in the first contact-accessibility domain. Multivariate linear regression showed that HVC, married participants, aged 60 and older, satisfied with the services, receiving six or more visits, and those with medical expenditures over 20% of their total family expenditures, were also positively associated with better primary care quality. Conclusions: This study demonstrates that villagers receiving medical care at HVCs perceived better primary care than those at PVCs and VVCs. In order to improve the quality of primary care at VCs, it is necessary to increase government subsidies for public service packages, tighten the township hospital's supervision of PVCs and VVCs, and develop performance-based incentive plans to motivate improvements in the accessibility of HVCs.

Suggested Citation

  • Shanshan Feng & Leiyu Shi & Jiazhi Zeng & Wen Chen & Li Ling, 2017. "Comparison of Primary Care Experiences in Village Clinics with Different Ownership Models in Guangdong Province, China," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-14, January.
    • Handle: RePEc:plo:pone00:0169241
    DOI: 10.1371/journal.pone.0169241
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    1. Xiaolin Wei & Haitao Li & Nan Yang & Samuel Y S Wong & Onikepe Owolabi & Jianguang Xu & Leiyu Shi & Jinling Tang & Donald Li & Sian M Griffiths, 2015. "Comparing Quality of Public Primary Care between Hong Kong and Shanghai Using Validated Patient Assessment Tools," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-15, March.
    2. Jane Griffin, 1996. "The Future of Primary Care," Monograph 000418, Office of Health Economics.
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    1. Wenhua Wang & Jeannie Haggerty & Ekaterina (Katya) Loban & Xiaoyun Liu, 2019. "Evaluating Primary Health Care Performance from User Perspective in China: Review of Survey Instruments and Implementation Issues," IJERPH, MDPI, vol. 16(6), pages 1-14, March.
    2. Aiyun Chen & Shanshan Feng & Liang Zhang & Leiyu Shi, 2020. "Comparison of Patients’ Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China," IJERPH, MDPI, vol. 17(13), pages 1-16, July.
    3. Min Su & Zhongliang Zhou & Yafei Si & Sean Sylvia & Gang Chen & Yanfang Su & Scott Rozelle & Xiaolin Wei, 2021. "Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study," IJERPH, MDPI, vol. 18(10), pages 1-16, May.

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