Quality of primary health care in China: challenges and recommendations
Fecha
2020Autor
Krumholz, Harlan M
Yip, Winnie
Keung Cheng, Kar
Maeseneer, Jan De
Meng, Qingyue
Mossialos, Elias
Li, Chuang
Lu, Jiapeng
Zhang, Qiuli
Roman Xu, Dong
Li, Liming
Normand, Sharon-Lise T
Peto, Richard
Li, Jing
Wang, Zengwu
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
Zhu, Shanzhu
Hu, Shengshou
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Resumen
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 healthcare 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.
Palabras clave
Primary health care; COVID-19; ChinaEnlace al recurso
https://doi.org/10.1016/S0140-6736(20)30122-7Colecciones
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