title: China's rural public health system performance: a cross-sectional study.
abstract: BACKGROUND
  In the past three years, the Government of China initiated health reform with rural public health system construction to achieve equal access to public health services for rural residents. The study assessed trends of public health services accessibility in rural China from 2008 to 2010, as well as the current situation about the China's rural public health system performance.
  
  
  METHODS
  The data were collected from a cross-sectional survey conducted in 2011, which used a multistage stratified random sampling method to select 12 counties and 118 villages from China. Three sets of indicators were chosen to measure the trends in access to coverage, equality and effectiveness of rural public health services. Data were disaggregated by provinces and by participants: hypertension patients, children, elderly and women. We examined the changes in equality across and within region.
  
  
  RESULTS
  China's rural public health system did well in safe drinking water, children vaccinations and women hospital delivery. But more hypertension patients with low income could not receive regular healthcare from primary health institutions than those with middle and high income. In 2010, hypertension treatment rate of Qinghai in Western China was just 53.22% which was much lower than that of Zhejiang in Eastern China (97.27%). Meanwhile, low performance was showed in effectiveness of rural public health services. The rate of effective treatment for controlling their blood pressure within normal range was just 39.7%.
  
  
  CONCLUSIONS
  The implementation of health reform since 2009 has led the public health development towards the right direction. Physical access to public health services had increased from 2008 to 2010. But, inter- and intra-regional inequalities in public health system coverage still exist. Strategies to improve the quality and equality of public health services in rural China need to be considered.
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China ; Institute of Medical Information, Center for Health Policy and Management, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Miaomiao
authors.initials: M
authors.lastname: Tian
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Da
authors.initials: D
authors.lastname: Feng
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China ; School of Management, Jiangsu University, Zhanjiang, Jiangsu, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Yingchun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Sun
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Yuanxi
authors.initials: Y
authors.lastname: Xiang
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yuan
authors.affiliation: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Zhanchun
authors.initials: Z
authors.lastname: Feng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002681:China; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011634:Public Health / Q000191:economics / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult