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Research ArticleFamily Medicine World Perspective

Underuse of Primary Care in China: The Scale, Causes, and Solutions

Dan Wu and Tai Pong Lam
The Journal of the American Board of Family Medicine March 2016, 29 (2) 240-247; DOI: https://doi.org/10.3122/jabfm.2016.02.150159
Dan Wu
From the Department of Family Medicine and Primary Care, Faculty of Medicine, The University of Hong Kong, Hong Kong.
MSc
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Tai Pong Lam
From the Department of Family Medicine and Primary Care, Faculty of Medicine, The University of Hong Kong, Hong Kong.
MD, PhD
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    Figure 1.

    Changing trend in the percentage of outpatient visits, by type of facility, from 2005 to 2013 in China. Sources: China Health Statistics Yearbooks 2011 to 2014.

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    Table 1. Outpatient Visits to Three Types of Facility, by Region, from 2009 to 2013
    RegionType of Facility20092010201120122013P Value
    Eastern ChinaHospital1064 (39)1148 (39)1285 (41)1438 (41)1547 (42).016
    Primary careNA1663 (57)1754 (56)1914 (55)2036 (55).056
    OthersNA96 (3)109 (3)125 (4)128 (3).742
    Central ChinaHospital439 (31)455 (30)494 (30)558 (31)600 (32).319
    Primary careNA1021 (67)1095 (67)1173 (66)1226 (65).056
    OthersNA45 (3)49 (3)57 (3)59 (3).193
    Western ChinaHospital419 (31)436 (31)480 (32)546 (34)595 (35).01
    Primary careNA927 (66)957 (64)1022 (63)1062 (62).017
    OthersNA46 (3)49 (3)56 (3)61 (4).225
    • Data are million visits (%).

    • Source: China Health Statistics Yearbooks 2010 to 2014.

    • View popup
    Table 2. Distribution of Licensed Doctors and Registered Nurses by Type of Facility in 2013
    DoctorsNurses
    Hospitals1,503,184 (54)2,041,367 (73)
    Primary care1,050,067 (38)576,630 (21)
    Public health/others241,503 (8)165,124 (6)
    Total2,794,754 (100)2,783,121 (100)
    • Data are n (%).

    • Source: China Health Statistics Yearbook 2014.

    • View popup
    Table 3. Education Level of Primary Care Practitioners by Type of Health Facility in China in 2013
    Education levelLicensed Doctors or Assistant DoctorsVillage Practitioners (Village Clinics)
    THCsCHCs and CHSsVillage Clinics
    Bachelor's degree or higher11.937.10.70.1
    Postsecondary diploma43.339.515.04.6
    Secondary vocational school40.720.379.881.4
    High school or less4.13.14.513.9
    • Data are percentages.

    • Source: China Health Statistics Yearbook 2014.

    • CHC, community health center (in urban cities); CHS, community health station (satellite clinic affiliated with community health centers in urban cities); THC, township health center (in rural areas).

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The Journal of the American Board of Family     Medicine: 29 (2)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 2
March-April 2016
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Underuse of Primary Care in China: The Scale, Causes, and Solutions
Dan Wu, Tai Pong Lam
The Journal of the American Board of Family Medicine Mar 2016, 29 (2) 240-247; DOI: 10.3122/jabfm.2016.02.150159

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Underuse of Primary Care in China: The Scale, Causes, and Solutions
Dan Wu, Tai Pong Lam
The Journal of the American Board of Family Medicine Mar 2016, 29 (2) 240-247; DOI: 10.3122/jabfm.2016.02.150159
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