The institutional primary healthcare service quality and patients’ experiences in Chinese community health centres: results from the Greater Bay Area study, China

Abstract

Background The goal of this paper was to assess the quality of primary healthcare services at community health centres (CHCs) from the demand (patient) and supplier (healthcare service institution) angles. Methods This study was conducted at six CHCs in the Greater Bay Area of China. Between August and October 2019, 1,568 patients were recruited (55.8% women and 44.2% men). We evaluated the service quality of CHCs using the National Committee for Quality Assurance Patient-Centred Medical Home (NCQA-PCMH) recognition questionnaire. We assessed patients’ experiences with medical and health services using the Primary Care Assessment Tools (PCAT). Results PCAT total and sub-domains scores were significantly difference at the six CHCs (P < 0.001). Among the six CHCs, Shayuan CHC had the highest PCAT total and sub-domain scores and the highest NCQA-PCMH total and sub-domain scores, as well. Older (> 60 years), female, lower education, and employee medical-insured individuals had better patient experiences. Conclusions Our results indicate that CHCs could improve their service quality by improving both institutional health service quality based on NCQA-PCMH assessment and patient experiences based on PCAT scales. These findings can help inform patient-centred primary healthcare policy and management.

Evaluation and countermeasures of contracted services of Chinese family doctors from demanders’ point of view — a case study of a city

“…PCAT demand side version is a measurement scale proposed by WHO to assess the standard of healthcare services offered by primary healthcare facilities based on the features of fundamental medical services [ 38 , 39 ]. The measurement dimensions of the PCAT, such as initial contact, continuous, coordinated, and comprehensive, align with the contracted service goals of family doctors implemented in China.…”

The quality of migrant patients’ primary healthcare experiences and patient-centered medical home achievement by community health centers: results from the China greater bay area study

“…The instrument is valid, reliable, and widely used in China and other countries [ 23 – 27 ]. The Chinese version of the original simplified PCAT has a reliability coefficient of 0.963, an acceptable test–retest reliability coefficient of 0.7 [ 21 ], and inclusion of various attributes of PHC [ 14 , 21 ]. These include dimension B, first-contact utilization (the extent to which the primary care provider performs a gatekeeper function); C, first-contact access (whether patients can contact a physician in time when they need medical and health service); D, ongoing care (the continuous relationship between physicians and patients in primary care institutions); E, coordination of care (the interpersonal linkage of care among different levels of providers); F, coordination information systems (informational linkage of care through the use of an electronic information system); G, comprehensiveness of service available (the ability to perform a wide range PHC service); H, comprehensiveness of service provided (the appropriate provision of service during consultations by a PHC provider), and three derivative dimensions: I, Family Centeredness (the recognition of the family as a major participant in the diagnosis, treatment, and recovery of patients); J, Community Orientation (whether CHCs fully consider the needs of patients in the implementation of health service) and K, Cultural Competence (the provision of care that respects the beliefs, interpersonal styles, attitudes and behaviors of people as they influence health).…”

“…Our previous study examined CHC service quality from patients’ and providers’ perspectives. Improved CHC service quality, as determined by the National Committee for Quality Assurance Patient-Centered Medical Home (NCQA-PCMH), improved the quality of patients’ PHC experiences, as determined by the PCAT [ 21 ]. Unfortunately, the effects of CHC service quality on migrant patients’ healthcare experiences remain unclear.…”

A scale for measuring healthcare service quality incorporating patient-centred care and using a psychometric analytics framework

“…Studies have been largely confined to users of healthcare services in developed countries (e.g. Mayo Clinic Arizona, USA, Kennedy et al, 2019; community health centres in the Greater Bay Area of China, Liu et al, 2021; public/private healthcare sectors in London, Owusu-Frimpong et al, 2010), so the underlying factorial structures based on specific populations in less-developed countries need to be further investigated. Further, the measurements employed need to be psychometrically validated.…”

“…Mayo Clinic Arizona, USA, Kennedy et al. , 2019; community health centres in the Greater Bay Area of China, Liu et al. , 2021; public/private healthcare sectors in London, Owusu-Frimpong et al.…”