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Open Access Research article

Analysis of factors influencing the outpatient workload at Chinese health centres

Jing Xu1, Wenxin Wang1, Yongbin Li1, Juan Zhang1, Milena Pavlova2, Hua Liu3, Ping Yin4* and Zuxun Lu1*

Author Affiliations

1 Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei Province, 430030, PR China

2 Department of Health Organisation, Policy and Economics, Faculty of Health, Medicine and Life Sciences, CAPHRI, Maastricht University Medical Centre, Maastricht University, The Netherlands

3 Department of Child Health Care of Wuhan City Maternal and Child Health Care Center, 100 Xianggang Road, Wuhan, Hubei Province, 430030, PR China

4 Department of Epidemiology and Health Statistics, School of Public Health in Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei Province, 430030, PR China

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BMC Health Services Research 2010, 10:151  doi:10.1186/1472-6963-10-151

Published: 5 June 2010

Abstract

Background

Although the community health service system is now established in China, the utilisation of the community health service institutions is low due to the lack of a gate-keeping role of the primary health service providers and referrals among the three-tiered health service institutions. In addition to this, patients who can afford to pay, often seek best services in big hospitals to guarantee the quality of care. Thus, the need of guiding the patients to the community health services and increasing the utilisation of the community health service institutions is becoming an urgent problem, which hinders the future development of community health services. This study focuses on the question of how to increase the utilisation of Chinese community health centres (HCs).

Methods

A cross-sectional Base-line Survey of Chinese City Community Health Service System Building using the multi-staged cluster sampling was conducted to collect data from all HCs in 28 key contact cities. Relevant indicators of totally 1790 HCs were analysed. The statistical methods included ANONVA and logistic regression.

Results and Conclusions

The analysis suggested several key factors for increasing the outpatient workload (OW) at the HCs: establishing an adequate referral system among the different levels of the health system; enhancing the qualification of health personnel and increasing the compensation by the health insurance for services provided at HCs. Other key factors with a positive effect on the OW included: the government ownership of the HCs, the scale of the institutions, the medical equipment used, the mix of health services provided, and the women in childbearing age in the residence.