Quality of primary health care in China: challenges and recommendations.

COVID-19 China Continuity of Patient Care Coronavirus Infections Fee-for-Service Plans Humans Pandemics Physicians, Primary Care / education Pneumonia, Viral Primary Health Care / organization & administration Quality of Health Care

Journal

Lancet (London, England)
ISSN: 1474-547X
Titre abrégé: Lancet
Pays: England
ID NLM: 2985213R

Informations de publication

Date de publication:
06 06 2020
Historique:
received: 12 09 2019
revised: 30 12 2019
accepted: 14 01 2020
entrez: 8 6 2020
pubmed: 9 6 2020
medline: 11 6 2020
Statut: ppublish

Résumé

China has substantially increased financial investment and introduced favourable policies for strengthening its primary health care system with core responsibilities in preventing and managing chronic diseases such as hypertension and emerging infectious diseases such as coronavirus disease 2019 (COVID-19). However, widespread gaps in the quality of primary health care still exist. In this Review, we aim to identify the causes for this poor quality, and provide policy recommendations. System challenges include: the suboptimal education and training of primary health-care practitioners, a fee-for-service payment system that incentivises testing and treatments over prevention, fragmentation of clinical care and public health service, and insufficient continuity of care throughout the entire health-care system. The following recommendations merit consideration: (1) enhancement of the quality of training for primary health-care physicians, (2) establishment of performance accountability to incentivise high-quality and high-value care; (3) integration of clinical care with the basic public health services, and (4) strengthening of the coordination between primary health-care institutions and hospitals. Additionally, China should consider modernising its primary health-care system through the establishment of a learning health system built on digital data and innovative technologies.

Identifiants

DOI: 10.1016/S0140-6736(20)30122-7 PMID: 32505251 PMC: PMC7272159
pubmed: 32505251
pii: S0140-6736(20)30122-7
doi: 10.1016/S0140-6736(20)30122-7
pmc: PMC7272159
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1802-1812

Subventions

Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

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Auteurs

Xi Li (X)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.

Harlan M Krumholz (HM)

Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine and the Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.

Winnie Yip (W)

Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.

Kar Keung Cheng (KK)

Department of Health Care Policy, Harvard Medical School, Boston, MA, USA; General Practice Development and Research Center, Peking University Health Science Center, Beijing, China.

Jan De Maeseneer (J)

Department of Public Health and Primary Care, Center of Family Medicine, Ghent University, Ghent, Belgium.

Qingyue Meng (Q)

School of Public Health, Peking University Health Science Center, Beijing, China.

Elias Mossialos (E)

Department of Health Policy, London School of Economics and Political Science, Institute of Global Health Innovation, Imperial College London, London, UK.

Chuang Li (C)

Health Commission of Shenzhen Municipality, Shenzhen, China.

Jiapeng Lu (J)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.

Meng Su (M)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Qiuli Zhang (Q)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.

Dong Roman Xu (DR)

Sun Yat-sen Global Health Institute, Sun Yat-sen University School of Public Health, and Institute of State Governance, Guangzhou, China.

Liming Li (L)

School of Public Health, Peking University Health Science Center, Beijing, China.

Sharon-Lise T Normand (ST)

Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Richard Peto (R)

Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Jing Li (J)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.

Zengwu Wang (Z)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Hongbing Yan (H)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.

Runlin Gao (R)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Somsak Chunharas (S)

National Health Foundation, Bangkok, Thailand.

Xin Gao (X)

Xizhuangzi Village Clinic, Jinchang, China.

Raniero Guerra (R)

Director General Office, WHO Headquarters, Geneva, Switzerland.

Huijie Ji (H)

Yaojia Township Primary Care Clinic, Zhengzhou, China.

Yang Ke (Y)

School of Oncology, Peking University Health Science Center, Beijing, China.

Zhigang Pan (Z)

Department of General Practice, Zhongshan Hospital of Shanghai Medical College Fudan University, Shanghai, China.

Xianping Wu (X)

Sichuan Center for Disease Control and Prevention, Chengdu, China.

Shuiyuan Xiao (S)

Xiangya School of Public Health, Central South University, Changsha, China.

Xinying Xie (X)

Health Commission of Yunnan Province, Kumming, China.

Yujuan Zhang (Y)

Jijie Township Primary Care Clinic, Gejiu, China.

Jun Zhu (J)

National Office for Maternal and Child Health Surveillance of China, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.

Shanzhu Zhu (S)

Department of General Practice, Zhongshan Hospital of Shanghai Medical College Fudan University, Shanghai, China.

Shengshou Hu (S)

National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China. Electronic address: huss@fuwaihospital.org.

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Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Quality of primary health care in China:...
questionsmedicales.fr › Régions géographiques › Asie › Extrême-Orient › Chine › Quality of primary health care in China:...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Continuité des soins › Quality of primary health care in China:...
questionsmedicales.fr › Infection › Maladies virales › Infections à virus à ARN › Infections à Nidovirales › Infections à Coronaviridae › Infections à coronavirus › Quality of primary health care in China:...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Pratique professionnelle › Pratique professionnelle privée › Régimes de rémunération à l'acte › Quality of primary health care in China:...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Quality of primary health care in China:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Épidémies de maladies › Épidémies › Pandémies › Quality of primary health care in China:...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › Médecins › Médecins de premier recours › Quality of primary health care in China:...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › Quality of primary health care in China:...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Quality of primary health care in China:...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Quality of primary health care in China:...