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- Title
Comparison of health care utilization among users of public and private community health centres in urban China.
- Authors
Shen, Menghan; He, Wen; Li, Linyan; Wu, Yushan
- Abstract
<bold>Background: </bold>In China, the government has encouraged the participation of private sector facilities in primary care to improve health care quality.<bold>Objective: </bold>We compare health care utilization patterns among patients who select private versus public community health centres (CHCs) for reimbursed outpatient services.<bold>Methods: </bold>This paper uses data from the Urban Employee Basic Medical Insurance scheme from 2013 to 2016 in one of the largest cities in China. We used a Poisson model and a logistic model to examine outcomes on monthly outpatient visits and the probability of hospitalization, respectively.<bold>Results: </bold>Compared with being a user of a public CHC, being a user of a private CHC is associated with a 26.2% lower incidence rate of outpatient visits to hospitals [95% confidence interval (CI): 30.1-21.8%] and no difference in rates of visits to CHCs or hospitalization. Among patients with diabetes or hypertension, being a user of a private CHC is associated with a 12.9% lower incidence rate of outpatient visits to CHCs (95% CI: 19.8-5.4%), a 25.6% lower incidence rate of outpatient visits to hospitals (95% CI: 21.4-19.5%) and 22.3% higher odds of hospitalization (95% CI: 3.5-44.7%).<bold>Conclusion: </bold>Being a user of a private CHC is associated with a reduction in outpatient visits to hospitals, which aligns with the goal of reducing hospital congestion at the outpatient level. For patients with chronic diseases, being a user of a private CHC is associated with a higher probability of hospitalization. More research is needed to understand the reason for this difference.
- Subjects
CHINA; PRIVATE communities; COMMUNITY centers; MEDICAL care; PUBLIC health; URBAN health
- Publication
Family Practice, 2020, Vol 37, Issue 6, p738
- ISSN
0263-2136
- Publication type
journal article
- DOI
10.1093/fampra/cmaa058