دورية أكاديمية
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Improving access to primary health care through financial innovation in rural China: a quasi-experimental synthetic difference-in-differences approach.

التفاصيل البيبلوغرافية
العنوان: Improving access to primary health care through financial innovation in rural China: a quasi-experimental synthetic difference-in-differences approach.
المؤلفون: Zeng Z; Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China.; Office of Policy Research, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China., Luo Y; Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China., Tao W; Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China., Zhang R; Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China., Zeng B; Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China., Yao J; Chinese Academy of Medical Sciences & Peking Union Medical College, No.9, Dongdan Santiao, Beijing, 100730, China. yaojianhong@pumc.edu.cn., Zhang W; West China Biomedical Big Data Center, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041, Sichuan, China. Weizhanghx@163.com.; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China. Weizhanghx@163.com.
المصدر: BMC primary care [BMC Prim Care] 2024 Jun 01; Vol. 25 (1), pp. 195. Date of Electronic Publication: 2024 Jun 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 9918300889006676 Publication Model: Electronic Cited Medium: Internet ISSN: 2731-4553 (Electronic) Linking ISSN: 27314553 NLM ISO Abbreviation: BMC Prim Care Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central Ltd., [2022]-
مواضيع طبية MeSH: Primary Health Care*/economics , Primary Health Care*/organization & administration , Health Services Accessibility*/economics , Health Care Reform*/economics, China ; Humans ; Health Expenditures ; Rural Health Services/economics ; Rural Population ; Healthcare Financing
مستخلص: Background: Inadequate financing constrains primary healthcare (PHC) capacity in many low- and middle-income countries, particularly in rural areas. This study evaluates an innovative PHC financing reform in rural China that aimed to improve access to healthcare services through supply-side integration and the establishment of a designated PHC fund.
Methods: We employed a quasi-experimental synthetic difference-in-differences (SDID) approach to analyze county-level panel data from Chongqing Province, China, spanning from 2009 to 2018. The study compared the impact of the reform on PHC access and per capita health expenditures in Pengshui County with 37 other control counties (districts). We assessed the reform's impact on two key outcomes: the share of outpatient visits at PHC facilities and per capita total PHC expenditure.
Results: The reform led to a significant increase in the share of outpatient visits at PHC facilities (14.92% points; 95% CI: 6.59-23.24) and an increase in per capita total PHC expenditure (87.30 CNY; 95% CI: 3.71-170.88) in Pengshui County compared to the synthetic control. These effects were robust across alternative model specifications and increased in magnitude over time, highlighting the effectiveness of the integrated financing model in enhancing PHC capacity and access in rural China.
Conclusions: This research presents compelling evidence demonstrating that horizontal integration in PHC financing significantly improved utilization and resource allocation in rural primary care settings in China. This reform serves as a pivotal model for resource-limited environments, demonstrating how supply-side financing integration can bolster PHC and facilitate progress toward universal health coverage. The findings underscore the importance of sustainable financing mechanisms and the need for policy commitment to achieve equitable healthcare access.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Health financing; Pooled funds; Primary health care; Rural Health; Synthetic difference-in-differences; Universal health coverage
تواريخ الأحداث: Date Created: 20240602 Date Completed: 20240602 Latest Revision: 20240607
رمز التحديث: 20240607
مُعرف محوري في PubMed: PMC11143622
DOI: 10.1186/s12875-024-02450-0
PMID: 38824504
قاعدة البيانات: MEDLINE
الوصف
تدمد:2731-4553
DOI:10.1186/s12875-024-02450-0