Comparing quality of primary healthcare between public and private providers in China: study protocol of a cross-sectional study using unannounced standardised patients in seven provinces of China
Yaolong Chen,
Zhongliang Zhou,
Mengyao Hu,
Jing Liao,
Yiyuan Cai,
Jay Pan,
Nan Zhang,
Xiaohui Wang,
Hua He,
Wenjie Gong,
Yue Cai,
Yaoguang Zhang,
Ruixin Wang,
Dong Xu,
Xiaochen Dai,
Kwun Chuen Gary Chan,
Xiaohua YING,
Qingping Xue,
Chi-Man (Winnie) Yip
Affiliations
Yaolong Chen
Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
Zhongliang Zhou
School of Public Policy and Administration, Xi`an Jiaotong University, Xi`an, China
Mengyao Hu
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
Jing Liao
Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
Yiyuan Cai
School of Public Health, Guizhou Medical University, Guiyang, China
Jay Pan
Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
Nan Zhang
Department of Health Management, School of Health Management, Inner Mongolia Medical University, Hohhot, China
Xiaohui Wang
School of Public Health, Lanzhou University, Lanzhou, China
Hua He
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
Wenjie Gong
School of Public Health, Central South University, Changsha, China
Yue Cai
Center for Health Statistics and Information, National Health Commission, Beijing, China
Yaoguang Zhang
1 Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing, China
Ruixin Wang
School of Public Health, Sun Yat-sen University, Guangzhou, China
Dong Xu
ACACIA Lab for Health Systems Strengthening and Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
Xiaochen Dai
School of Medicine, University of Washington, Seattle, Washington, USA
Kwun Chuen Gary Chan
Department of Biostatistics, University of Washington, Seattle, Washington, USA
Xiaohua YING
Department of Health Economics, Fudan University School of Public Health, Shanghai, People`s Republic of China
Qingping Xue
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
Chi-Man (Winnie) Yip
Department of Global Health and Population, Harvard University, Cambridge, Massachusetts, USA
Introduction The Chinese government has encouraged the development of private sector in delivering healthcare, including primary healthcare (PHC) in the new round of national health reform since 2009. However, the debate about the role of the private sector in achieving universal health coverage continues with poor support from theories and empirical evidence. This study intends to compare the quality of PHC services between the private and public providers in seven provinces in China, using unannounced standardised patients (USPs).Methods We are developing and validating 13 USP cases most commonly observed in the PHC setting. Six domains of quality will be assessed by the USP: effectiveness, safety, patient centredness, efficiency, timeliness and equity. The USP will make 2200 visits to 705 public and 521 private PHC institutions across seven provinces, following a multistage clustered sample design. Using each USP-provider encounter as the analytical unit, we will first descriptively compare the raw differences in quality between the private and public providers and then analyse the association of ownership types and quality, using propensity score weighting.Ethics and dissemination The study was primarily funded by the National Natural Science Foundation of China (#71974211, #71874116 and # 72074163) and was also supported by the China Medical Board (#16-260, #18-300 and #18-301), and have received ethical approval from Sun Yat-sen University (#2019–024). The validated USP tool and the data collected in this study will be freely available for the public after the primary analysis of the study.Trial registration number Chinese Clinical Trial Registry: #ChiCTR2000032773.
