What should the government do regarding health policy-making to develop community health care in Shanghai?

Abstract

Although there have been other policies interacting with the impact of GCP, GCP reforms implemented in the pilot districts at different times (as well as the later, standardized GCP system) have been effective in enabling CHCs to focus on providing quality public health services and appropriate medical treatment, rather than concentrating upon profit and loss. The impact of the standardized GCP system was further confirmed by cross-sectional comparisons of some broad indicators, in terms of medical cost, quality of medical service, and coverage of public health service, between the pilot districts and control districts. However, uncertainties exit when looking at individual indicators. Some indicators (see pp. 11-13 and Table 5), such as the service contracting rate with CHCs and the proportion of residents with health records set up, were not sufficient to allow for reasonable estimation of the impact of the GCP. In part this was due to inconsistent data collections. Some indicators, on the other hand, such as the standard management rate of residents with hypertension, were usually affected by the changing government's role over the period. Meanwhile, variations among the three pilot districts with different socioeconomic profiles were observed by several individual indicators within the evaluation index. Further research is needed to investigate the impact of other solutions--such as user fee removal and "zero margin profit" of medicine in CHCs--in order to coordinate other policies with the GCP to improve CHCs more effectively. Longer term observation of impact of the standardized GCP system, as well as other influencing factors in Shanghai based on quality data collected on a standard basis, may help improve policy. Moreover, variations in residents' expectations of barriers in access to CHC services and in healthcare-seeking behavior need to be taken into consideration when designing GCP systems for areas with different socioeconomic profiles in order to meet the different health needs which are a consequence of the major socioeconomic changes in Shanghai (and China in general, it could be agreed).

Patient related factors for optimal blood pressure control in patients with hypertension

“…13,14 The poor medication adherence can be due to a number of factors, such as multiple dose regimens, poor eye sights or hands disabilities in the elderly, 13,14 or in some countries, financial constraints 7 . In the present study, 65% of the patients reported poor medication adherence in the 4-week period prior to the interviews at our clinics.…”

Evolving health policy for primary care in the Asia Pacific region

“…7 There is poor referral between primary, secondary, and tertiary care, resulting in disordered medical consultations. The current challenges include how to provide high-quality primary care.…”

Evaluation of Taiwan's National Health Insurance policy: an importance–satisfaction analysis

“…From a similar perspective, Yu et al . () focused on cross‐sectional comparisons of certain broad indicators: medical cost, the quality of medical service, and coverage of healthcare services. According to the OECD, four policy touch points in health systems can influence policy performance: health system inputs, health system design, monitoring mechanisms, and improvement systems, which include the perspectives of policy process and outcomes (OECD, ).…”