Zhongguo quanke yixue (Dec 2023)
Current Situation and Countermeasure of Medical Service Capacity of Primary Care Physicians in China
Abstract
Background With the promotion of "strengthening the primary care" measures, the number of primary healthcare professionals in China has increased significantly, but there is still a gap between the capacity of primary care physicians and basic medical needs of residents. Objective To understand the current situation of the medical service capacity of primary care physicians in different regions and between urban and rural areas of China, explore the strategies to improve the medical service capacity of primary care physicians in China. Methods In August 2020, an online questionnaire survey on 8 537 primary care physicians in the primary care institutions in eastern, central and western China by using the method of multi-stage stratified sampling combined with typical sampling. The questionnaire was designed based on the indexes in the part of medical service of the medical service capacity evaluation tool of primary care physicians previously developed by the research group, which was used to evaluate the competence of primary care physicians in four aspects of diagnosis and treatment of common diseases and frequent diseases, emergency treatment of critical illnesses, medical service coordination and traditional Chinese medicine services and assess the extent to which their competence met the needs of their work. The competence of primary care physicians and the extent to which their competence met the needs of their work were compared in different regions and levels of medical institutions. Results A total of 8 469 valid questionnaires were collected, with the recovery rate of 99.2%. There were 6 954 (82.1%), 4 283 (50.6%), 4 800 (56.7%) and 4 464 (52.7%) primary care physicians who had the ability of diagnosis and treatment of common diseases and frequent diseases, emergency treatment of critical illnesses, medical service coordination and traditional Chinese medicine services. The rate of medical competence of primary care physicians in the central region were higher than those in the eastern and western regions from the perspective of regional distribution, with statistically significant differences (P<0.017) ; there were significant differences in the rate of medical competence of primary care physicians between rural and urban areas from the perspective of institutional level (P<0.05). Except for diagnosis and treatment of common diseases and frequent diseases, the rates of medical competence of other medical services of the primary care physicians in the rural area were higher than those in the urban area (P<0.05), the medical competence rates of emergency treatment of critical illnesses and traditional Chinese medicine services of primary care physicians in village clinics were higher than those in community health service centers and township hospitals, with statistically significant difference (P<0.005). In terms of the rate of ability to meet work needs, the rates of primary care physicians were 97.2% (4 233/4 357), 96.2% (4 269/4 436), 95.2% (3 227/3 388), 92.3% (3 954/4 284) in diagnosis and treatment of common diseases and frequent diseases, emergency treatment of critical illnesses, medical service coordination and traditional Chinese medicine services; the rate of primary care physicians was higher in the eastern region than in the central and western regions (P<0.017), higher in urban areas than in rural areas (P<0.05), and higher in community health service centers than in village clinics (P<0.005), with statistically significant differences. Conclusion There is a shortage of high-quality personnel in the team of primary care physicians in China. The abilities of emergency treatment of critical illnesses, medical service coordination and traditional Chinese medicine services still needs to be strengthened. The overall rate of medical competence of primary care physicians in the central region, rural areas and village clinics is high, but the rate of ability to meet work needs is low. It is necessary to provide more support to primary care physicians in each region in terms of improving policies and training methods in accordance with local conditions.
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