Willingness rate of the first visit to primary healthcare services and the associated factors in China: a meta-analysis
Chong Liu A B , Lei Qiu A and Huimin Wang A C *A Research Institute of Management Science, Hohai University, No. 8 Fucheng West Road, Jiangning District, Nanjing 211100, Jiangsu, China.
B Personnel Department, Nanjing University of Finance and Economics, No. 3 Wenyuan Road, Xianlin Street, Qixia District, Nanjing 210023, Jiangsu, China.
C State Key Laboratory of Hydrology-Water Resources and Hydraulic Engineering, Hohai University, No. 1 Xikang Road, Gulou District, Nanjing 210098, Jiangsu, China.
Australian Journal of Primary Health 28(6) 459-468 https://doi.org/10.1071/PY21296
Submitted: 22 December 2021 Accepted: 2 June 2022 Published: 21 July 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: In September 2015, the State Council of China issued guidelines on building a hierarchical medical system, stating that the first visit rate to primary healthcare (PHC) facilities should be increased to 70% for all medical facilities by 2017. This meta-analysis aims to estimate the willingness of the first visit to PHC services in China after the year 2015 and identify its determinants.
Methods: A meta-analysis was conducted.
Results: The combined estimate from 23 studies in China for the willingness rate of the first visit to PHC services was 56% (95% CI: 47–65). Chronic diseases may be one source of heterogeneity. We identified five main associated factors with the pooled odds ratio ranging from 1.39 to 10.28, including fair self-reported health status; high understanding of service content; good service attitude; solid expertise and advanced diagnostic methods; and a good medical environment.
Conclusion: In comparison with China’s State Council recommendations, the willingness rate for the first visit to PHC services was significantly lower. The Government should develop strategies to facilitate the implementation of a hierarchical system for diagnosis and treatment.
Keywords: associated factor, China, first visit, health-seeking behaviour, hierarchical medical system, meta-analysis, primary health care, willingness rate.
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