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Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study

Citation

Su, Min; Zhou, Zhongliang; Si, Yafei; Sylvia, Sean; Chen, Gang; Su, Yanfang; Rozelle, Scott; & Wei, Xiaolin (2021). Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study. International Journal of Environmental Research and Public Health, 18(10), 5060.

Abstract

Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions between physicians and standardized patients across 63 CHCs in Xi'an, China. We measured the quality of primary care on seven criteria: (1) adherence to checklists, (2) correct diagnosis, (3) correct treatment, (4) number of unnecessary exams and drugs, (5) diagnosis time, (6) expense of visit, (7) patient-centered communication. Significant quality differences were observed between public CHCs and private CHCs. Private CHC physicians performed 4.73 percentage points lower of recommended questions and exams in the checklist. Compared with private CHCs, public CHC providers were more likely to give a higher proportion of correct diagnosis and correct treatment. Private CHCs provided 1.42 fewer items of unnecessary exams and provided 0.32 more items of unnecessary drugs. Private CHC physicians received a 9.31 lower score in patient-centered communication. There is significant quality inequality in different primary care models. Public CHC physicians might provide a higher quality of service. Creating a comprehensive, flexible, and integrated health care system should be considered an effective approach towards optimizing the management of CHC models.

URL

http://dx.doi.org/10.3390/ijerph18105060

Reference Type

Journal Article

Article Type

Regular

Year Published

2021

Journal Title

International Journal of Environmental Research and Public Health

Author(s)

Su, Min
Zhou, Zhongliang
Si, Yafei
Sylvia, Sean
Chen, Gang
Su, Yanfang
Rozelle, Scott
Wei, Xiaolin

Continent/Country

China