The primary health-care system in China

China has made remarkable progress in strengthening its primary health care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, which diminish its preparedness to care for one fifth of the world’s population with an aging issue and a growing prevalence of chronic non-communicable disease. These challenges include: inadequate education and qualifications in its workforce, aging and turnover among village doctors; fragmented health information technology systems and a paucity of digital data on everyday clinical practice; financial subsidies and incentives that fail to encourage cost savings and good performance; insurance policies that hamper the efficiency of care delivery; and a lack of a quality measurement and improvement system and poor control of risk factors, such as hypertension and diabetes. As China is deepening its health care reform, it has the opportunity to build an integrated, cooperative primary health care system using sound evidence and comprehensive action plans, bolstered by evidence-based performance indicators and incentives.