The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016
Abstract Background Since 2009, the Chinese government has been reforming the healthcare system and has committed to reinforcing increased use of primary care. To date, however, the Chinese healthcare system is still heavily reliant on hospital-based specialty care. Studies consistently show an asso...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-020-05193-7 |
| _version_ | 1811223904095567872 |
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| author | Zhuojun Luo Yuanzhu Ma Naiqi Ke Shuyi Xu Ruwei Hu Nan Hu Li Kuang |
| author_facet | Zhuojun Luo Yuanzhu Ma Naiqi Ke Shuyi Xu Ruwei Hu Nan Hu Li Kuang |
| author_sort | Zhuojun Luo |
| collection | DOAJ |
| description | Abstract Background Since 2009, the Chinese government has been reforming the healthcare system and has committed to reinforcing increased use of primary care. To date, however, the Chinese healthcare system is still heavily reliant on hospital-based specialty care. Studies consistently show an association between primary care and improved health outcomes, and the same association is also found among the disadvantaged population. Due to the “hukou” system, interprovincial migrants in the urban districts are put in a weak position and become the disadvantaged. Therefore, the aim of this study is to investigate whether greater supply and utilization of primary care was associated with reduced child mortality among the entire population and the interprovincial migrants in urban districts of Guangdong province, China. Methods An ecological study was conducted using a 3-year panel data with repeated measurements within urban districts in Guangdong province from 2014 to 2016, with 178 observations in total. Multilevel linear mixed effects models were applied to explore the associations. Results Higher visit proportion to primary care was associated with reductions in the infant mortality rate and the under-five mortality rate in both the entire population and the interprovincial migrants (p < 0.05) in the full models. The association between visit proportion to primary care and reduced neonatal mortality rate was significant among the entire population (p < 0.05) while it was insignificant among the interprovincial migrants (p > 0.05). Conclusions Our ecological study based in urban districts of Guangdong province found consistent associations between higher visit proportion to primary care and improvements in child health among the entire population and the interprovincial migrants, suggesting that China should continue to strengthen and develop the primary care system. The findings from China adds to the previously reported evidence on the association between primary care and improved health, especially that of the disadvantaged. |
| first_indexed | 2024-04-12T08:40:31Z |
| format | Article |
| id | doaj.art-3933b2a7682347449b8dec16893a2ab9 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-12T08:40:31Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-3933b2a7682347449b8dec16893a2ab92022-12-22T03:39:54ZengBMCBMC Health Services Research1472-69632020-04-0120111210.1186/s12913-020-05193-7The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016Zhuojun Luo0Yuanzhu Ma1Naiqi Ke2Shuyi Xu3Ruwei Hu4Nan Hu5Li Kuang6Department of Health Administration, School of Public Health, Sun Yat-sen UniversityGuangdong Women and Children HospitalDepartment of Health Administration, School of Public Health, Sun Yat-sen UniversitySchool of Finance, Guangdong University of Finance and EconomicsDepartment of Health Administration, School of Public Health, Sun Yat-sen UniversityDepartment of Internal Medicine, Family and Preventive Medicine, and Population Health Sciences, University of Utah School of Medicine and Huntsman Cancer InstituteDepartment of Health Administration, School of Public Health, Sun Yat-sen UniversityAbstract Background Since 2009, the Chinese government has been reforming the healthcare system and has committed to reinforcing increased use of primary care. To date, however, the Chinese healthcare system is still heavily reliant on hospital-based specialty care. Studies consistently show an association between primary care and improved health outcomes, and the same association is also found among the disadvantaged population. Due to the “hukou” system, interprovincial migrants in the urban districts are put in a weak position and become the disadvantaged. Therefore, the aim of this study is to investigate whether greater supply and utilization of primary care was associated with reduced child mortality among the entire population and the interprovincial migrants in urban districts of Guangdong province, China. Methods An ecological study was conducted using a 3-year panel data with repeated measurements within urban districts in Guangdong province from 2014 to 2016, with 178 observations in total. Multilevel linear mixed effects models were applied to explore the associations. Results Higher visit proportion to primary care was associated with reductions in the infant mortality rate and the under-five mortality rate in both the entire population and the interprovincial migrants (p < 0.05) in the full models. The association between visit proportion to primary care and reduced neonatal mortality rate was significant among the entire population (p < 0.05) while it was insignificant among the interprovincial migrants (p > 0.05). Conclusions Our ecological study based in urban districts of Guangdong province found consistent associations between higher visit proportion to primary care and improvements in child health among the entire population and the interprovincial migrants, suggesting that China should continue to strengthen and develop the primary care system. The findings from China adds to the previously reported evidence on the association between primary care and improved health, especially that of the disadvantaged.http://link.springer.com/article/10.1186/s12913-020-05193-7Utilization of primary careInterprovincial migrantsEcological studyChild healthMultilevel model |
| spellingShingle | Zhuojun Luo Yuanzhu Ma Naiqi Ke Shuyi Xu Ruwei Hu Nan Hu Li Kuang The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016 BMC Health Services Research Utilization of primary care Interprovincial migrants Ecological study Child health Multilevel model |
| title | The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016 |
| title_full | The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016 |
| title_fullStr | The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016 |
| title_full_unstemmed | The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016 |
| title_short | The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016 |
| title_sort | association between the supply and utilization of community based primary care and child health in a context of hospital oriented healthcare system in urban districts of guangdong china a panel dataset 2014 2016 |
| topic | Utilization of primary care Interprovincial migrants Ecological study Child health Multilevel model |
| url | http://link.springer.com/article/10.1186/s12913-020-05193-7 |
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