Quality of primary health care in China: challenges and recommendations

Research output: Contribution to journalArticle

Standard

Quality of primary health care in China : challenges and recommendations. / Xi, Li; Krumholz, Harlan M; Yip, Winnie; Cheng, KK; De Maeseneer, Jan ; Meng, Qingyue ; Mossialos, Elias A ; Li, Chuang ; Lu, Jiapeng ; Sun, Meng; Zhang, Qiuli ; Roman, Dong ; Li, Liming ; Normand, Sharon-Lise T ; Peto, Richard ; Li, Jing; Wang, Zhengwu ; Yan, Hongbing ; Gao, Runlin ; Chunharas, Somsak ; Gao, Xin; Guerra, Raniero ; Ji, Huijie ; Ke, Yang ; Pan, Zhigang; Wu, Xianping ; Xiao, Shuiyuan ; Xie, Xinying ; Zhang, Yujuan ; Zhu, Jun .

In: The Lancet, 15.01.2020.

Research output: Contribution to journalArticle

Harvard

Xi, L, Krumholz, HM, Yip, W, Cheng, KK, De Maeseneer, J, Meng, Q, Mossialos, EA, Li, C, Lu, J, Sun, M, Zhang, Q, Roman, D, Li, L, Normand, S-LT, Peto, R, Li, J, Wang, Z, Yan, H, Gao, R, Chunharas, S, Gao, X, Guerra, R, Ji, H, Ke, Y, Pan, Z, Wu, X, Xiao, S, Xie, X, Zhang, Y & Zhu, J 2020, 'Quality of primary health care in China: challenges and recommendations', The Lancet.

APA

Xi, L., Krumholz, H. M., Yip, W., Cheng, KK., De Maeseneer, J., Meng, Q., Mossialos, E. A., Li, C., Lu, J., Sun, M., Zhang, Q., Roman, D., Li, L., Normand, S-L. T., Peto, R., Li, J., Wang, Z., Yan, H., Gao, R., ... Zhu, J. (Accepted/In press). Quality of primary health care in China: challenges and recommendations. The Lancet.

Vancouver

Xi L, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q et al. Quality of primary health care in China: challenges and recommendations. The Lancet. 2020 Jan 15.

Author

Xi, Li ; Krumholz, Harlan M ; Yip, Winnie ; Cheng, KK ; De Maeseneer, Jan ; Meng, Qingyue ; Mossialos, Elias A ; Li, Chuang ; Lu, Jiapeng ; Sun, Meng ; Zhang, Qiuli ; Roman, Dong ; Li, Liming ; Normand, Sharon-Lise T ; Peto, Richard ; Li, Jing ; Wang, Zhengwu ; Yan, Hongbing ; Gao, Runlin ; Chunharas, Somsak ; Gao, Xin ; Guerra, Raniero ; Ji, Huijie ; Ke, Yang ; Pan, Zhigang ; Wu, Xianping ; Xiao, Shuiyuan ; Xie, Xinying ; Zhang, Yujuan ; Zhu, Jun . / Quality of primary health care in China : challenges and recommendations. In: The Lancet. 2020.

Bibtex

@article{6c45e5fadc6e4c1e89044fe0c59356fc,
title = "Quality of primary health care in China: challenges and recommendations",
abstract = "As part of its health care reform in the past decade, China has significantly increased financial investment and introduced favourable policies for primary health care. However, widespread gaps in the quality still exist, which has contributed to missed opportunities to promote population health. In this review, we aim to identify the causes for poor quality, and provide policy recommendations for improvement. These gaps include suboptimal screening, diagnosis, and treatment of diseases, which compromise health outcomes. System challenges include: suboptimal education and training of primary health care practitioners; a fee-for-service payment system that incentivizes testing and treatments over prevention; fragmentation of clinical care and public health service; insufficient continuity of care throughout the entire health care system. Now is an opportune time for China to strengthen the quality of its primary health care as the government is shifting its reform attention to {\textquoteleft}improving quality and enhancing efficiency ( ti zhi zeng xiao , 提质增效){\textquoteright}. The following recommendations merit consideration: enhancement of the quality of training for primary health care physicians and tailor continuing professional development for the current workforce; establishment of performance accountability to incentivize high-quality and high-value care; integration of clinical care with the basic public health services; and strengthening of the coordination between primary health care institutions and hospitals. Additionally, China should consider modernizing its PHC system through the establishment of a learning health system built on digital data and innovative technologies that can combine tools for accountability, efficiency, and improvement. Lessons from these strategies could serve as a model to other countries facing similar challenges.",
author = "Li Xi and Krumholz, {Harlan M} and Winnie Yip and KK Cheng and {De Maeseneer}, Jan and Qingyue Meng and Mossialos, {Elias A} and Chuang Li and Jiapeng Lu and Meng Sun and Qiuli Zhang and Dong Roman and Liming Li and Normand, {Sharon-Lise T} and Richard Peto and Jing Li and Zhengwu Wang and Hongbing Yan and Runlin Gao and Somsak Chunharas and Xin Gao and Raniero Guerra and Huijie Ji and Yang Ke and Zhigang Pan and Xianping Wu and Shuiyuan Xiao and Xinying Xie and Yujuan Zhang and Jun Zhu",
year = "2020",
month = jan
day = "15",
language = "English",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Quality of primary health care in China

T2 - challenges and recommendations

AU - Xi, Li

AU - Krumholz, Harlan M

AU - Yip, Winnie

AU - Cheng, KK

AU - De Maeseneer, Jan

AU - Meng, Qingyue

AU - Mossialos, Elias A

AU - Li, Chuang

AU - Lu, Jiapeng

AU - Sun, Meng

AU - Zhang, Qiuli

AU - Roman, Dong

AU - Li, Liming

AU - Normand, Sharon-Lise T

AU - Peto, Richard

AU - Li, Jing

AU - Wang, Zhengwu

AU - Yan, Hongbing

AU - Gao, Runlin

AU - Chunharas, Somsak

AU - Gao, Xin

AU - Guerra, Raniero

AU - Ji, Huijie

AU - Ke, Yang

AU - Pan, Zhigang

AU - Wu, Xianping

AU - Xiao, Shuiyuan

AU - Xie, Xinying

AU - Zhang, Yujuan

AU - Zhu, Jun

PY - 2020/1/15

Y1 - 2020/1/15

N2 - As part of its health care reform in the past decade, China has significantly increased financial investment and introduced favourable policies for primary health care. However, widespread gaps in the quality still exist, which has contributed to missed opportunities to promote population health. In this review, we aim to identify the causes for poor quality, and provide policy recommendations for improvement. These gaps include suboptimal screening, diagnosis, and treatment of diseases, which compromise health outcomes. System challenges include: suboptimal education and training of primary health care practitioners; a fee-for-service payment system that incentivizes testing and treatments over prevention; fragmentation of clinical care and public health service; insufficient continuity of care throughout the entire health care system. Now is an opportune time for China to strengthen the quality of its primary health care as the government is shifting its reform attention to ‘improving quality and enhancing efficiency ( ti zhi zeng xiao , 提质增效)’. The following recommendations merit consideration: enhancement of the quality of training for primary health care physicians and tailor continuing professional development for the current workforce; establishment of performance accountability to incentivize high-quality and high-value care; integration of clinical care with the basic public health services; and strengthening of the coordination between primary health care institutions and hospitals. Additionally, China should consider modernizing its PHC system through the establishment of a learning health system built on digital data and innovative technologies that can combine tools for accountability, efficiency, and improvement. Lessons from these strategies could serve as a model to other countries facing similar challenges.

AB - As part of its health care reform in the past decade, China has significantly increased financial investment and introduced favourable policies for primary health care. However, widespread gaps in the quality still exist, which has contributed to missed opportunities to promote population health. In this review, we aim to identify the causes for poor quality, and provide policy recommendations for improvement. These gaps include suboptimal screening, diagnosis, and treatment of diseases, which compromise health outcomes. System challenges include: suboptimal education and training of primary health care practitioners; a fee-for-service payment system that incentivizes testing and treatments over prevention; fragmentation of clinical care and public health service; insufficient continuity of care throughout the entire health care system. Now is an opportune time for China to strengthen the quality of its primary health care as the government is shifting its reform attention to ‘improving quality and enhancing efficiency ( ti zhi zeng xiao , 提质增效)’. The following recommendations merit consideration: enhancement of the quality of training for primary health care physicians and tailor continuing professional development for the current workforce; establishment of performance accountability to incentivize high-quality and high-value care; integration of clinical care with the basic public health services; and strengthening of the coordination between primary health care institutions and hospitals. Additionally, China should consider modernizing its PHC system through the establishment of a learning health system built on digital data and innovative technologies that can combine tools for accountability, efficiency, and improvement. Lessons from these strategies could serve as a model to other countries facing similar challenges.

UR - https://www.thelancet.com/journals/lancet/issue/current

M3 - Article

JO - The Lancet

JF - The Lancet

SN - 0140-6736

ER -