Document Type

Journal Article

Department/Unit

Department of Physical Education

Title

Comparison of three models of ownership of community health centres in China: A qualitative study

Language

English

Abstract

© The Author(s) 2015. Objectives: Community health centres are the main form of provision of primary care in China. There are three models: government managed, hospital managed and private. Our aim was to describe and compare primary care under the three ownership models. Methods: Four aspects of primary care were studied: services, organization, financing and human resources. Interviews were undertaken with 60 managerial and professional staff in 13 community health centres in the Pearl River Delta region in 2010. Three community health centres were selected in the capital city and two were selected from each of the other five cities. Thematic framework analysis was conducted. Results: Government-managed community health centres received the largest public funding, followed by hospitalmanaged community health centres, while private community health centres received the least. Private community health centres were the smallest in scale and provided lower quality public health services compared with the other two models. Patient out-of-pocket costs accounted for the majority of the revenue in all models of community health centres despite improved government funding for preventive services. General challenges such as the shortage of public funding, the exclusion of migrants in the funding for preventive services, low capacity in human resources and the separation of clinical and preventive care in community health centres were identified in all three models of community health centres. Conclusions: The ownership and management of a community health centre greatly influence the service it provides. Private community health centres are in a disadvantaged position to deliver high quality clinical and preventive care.

Keywords

China, Ownership models, Primary care

Publication Date

2015

Source Publication Title

Journal of Health Services Research and Policy

Volume

20

Issue

3

Start Page

162

End Page

169

Publisher

SAGE Publications

DOI

10.1177/1355819615579700

Link to Publisher's Edition

http://dx.doi.org/10.1177/1355819615579700

ISSN (print)

13558196

ISSN (electronic)

17581060

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