The ecology of medical care in Beijing

Abstract

Background: We presented the pattern of health care consumption, and the utilization of available resources by describing the ecology of medical care in Beijing on a monthly basis and by describing the socio-demographic characteristics associated with receipt care in different settings.

Methods: A cohort of 6,592 adults, 15 years of age and older were sampled to estimate the number of urban-resident adults per 1,000 who visited a medical facility at least once in a month, by the method of three-stage stratified and cluster random sampling. Separate logistic regression analyses assessed the association between those receiving care in different types of setting and their socio-demographic characteristics.

Results: On average per 1,000 adults, 295 had at least one symptom, 217 considered seeking medical care, 173 consulted a physician, 129 visited western medical practitioners, 127 visited a hospital-based outpatient clinic, 78 visited traditional Chinese medical practitioners, 43 visited a primary care physician, 35 received care in an emergency department, 15 were hospitalized. Health care seeking behaviors varied with socio-demographic characteristics, such as gender, age, ethnicity, resident census register, marital status, education, income, and health insurance status. In term of primary care, the gate-keeping and referral roles of Community Health Centers have not yet been fully established in Beijing.

Conclusions: This study represents a first attempt to map the medical care ecology of Beijing urban population and provides timely baseline information for health care reform in China.

Figure 1. The map of Beijing.

Figure 2. Monthly prevalence estimates of illness and the roles of different settings in the health-care utilization.

Data are for the Beijing urban resident population in 2012 (adult 15 years of age and older). Each box does not necessarily represent a subgroup of the larger box, i.e., some values are overlapping. The values are based on 1,000 persons.

Figure 3. The proportion of subjects who did not experience health problems in four health-care settings.

Four health care settings include traditional Chinese medical care, western medical care, primary care and hospital-based outpatient care. A1 is female, A2 is male, B1 is age under 55 years, B2 is age above 55 years, C1 is resident with “Hukou”, C2 is migrant. The values are based on 1,000 persons.