Effects of Healthcare Policies and Reforms at the Primary Level in China: From the Evidence of Shenzhen Primary Care Reforms from 2018 to 2019

Abstract

Countries worldwide are making efforts to achieve health equity. China focuses on the implementation of the policy goal of "improving the primary level" to eliminate the health equity gap. The main purpose of this study is to examine the effects of the healthcare reforms at the primary level in China and to analyze the key factors that can help to improve their effectiveness. From the perspectives of the policy attention mechanism and public policy analysis, this study will explore primary care reforms from policy formulation to policy implementation on the basis of grounded theory and empirical research on primary care reforms in Shenzhen, China, that was conducted from 2018 to 2019. The present study found that the government pays close attention to the medical level and service level of primary care services at the policy formulation phase but less attention to talent level and information sharing. At the same time, this study combined with empirical data from primary care centers in Shenzhen for the period covering 2018 to 2019 evaluates policy implementation and its effect. Multiple regression analysis revealed that the medical level, talent level, service level, and information sharing helped to develop primary care services and improved health equity. Nevertheless, this study reflects a deviation between policy formulation and policy implementation for the development of primary care policies. Empirical experience shows that the development of talent level and information sharing can significantly promote primary care services and health management. Therefore, this study implies that in the process of promoting the health equity at the primary level, more attention should be paid to the consistency between policy formulation and policy implementation. Additionally, the policy promotion and influence mechanism can be improved, particularly in terms of talent development and information sharing, in order to effectively promote the development of health equity at the primary level.

Keywords: health equity; policy formulation; policy implementation; primary care.

Figure 1

Scatter diagram of hypertension patient management and total number of GPs.

Figure 2

Scatter diagram of diabetes patient management and total number of GPs.

Figure 3

Scatter diagram of elderly management and total number of GPs.

Figure 4

Scatter diagram of hypertension patient management and total number of deputy chief physicians.

Figure 5

Scatter diagram of diabetes patient management and total number of deputy chief physicians.

Figure 6

Scatter diagram of elderly management and number of deputy chief physicians.