Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study

Min Su, Zhongliang Zhou, Yafei Si, Sean Sylvia, Gang Chen, Yanfang Su, Scott Rozelle and Xiaolin Wei
Additional contact information
Min Su: School of Public Administration, Inner Mongolia University, Hohhot 010070, China
Zhongliang Zhou: School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
Yafei Si: School of Risk & Actuarial Studies and CEPAR, University of New South Wales, Sydney, NSW 2052, Australia
Gang Chen: Monash Business School, Monash University, Clayton, VIC 3800, Australia
Yanfang Su: School of Medicine, University of Washington, Seattle, WA 98195, USA
Xiaolin Wei: Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada

IJERPH, 2021, vol. 18, issue 10, 1-16

Abstract: Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions between physicians and standardized patients across 63 CHCs in Xi’an, China. We measured the quality of primary care on seven criteria: (1) adherence to checklists, (2) correct diagnosis, (3) correct treatment, (4) number of unnecessary exams and drugs, (5) diagnosis time, (6) expense of visit, (7) patient-centered communication. Significant quality differences were observed between public CHCs and private CHCs. Private CHC physicians performed 4.73 percentage points lower of recommended questions and exams in the checklist. Compared with private CHCs, public CHC providers were more likely to give a higher proportion of correct diagnosis and correct treatment. Private CHCs provided 1.42 fewer items of unnecessary exams and provided 0.32 more items of unnecessary drugs. Private CHC physicians received a 9.31 lower score in patient-centered communication. There is significant quality inequality in different primary care models. Public CHC physicians might provide a higher quality of service. Creating a comprehensive, flexible, and integrated health care system should be considered an effective approach towards optimizing the management of CHC models.

Keywords: primary care; quality; public CHCs; private CHCs; standardized patient; China (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/10/5060/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/10/5060/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:10:p:5060-:d:552079

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().