title: Focus on vulnerable populations and promoting equity in health service utilization--an analysis of visitor characteristics and service utilization of the Chinese community health service.
abstract: BACKGROUND
  Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents.
  
  
  METHODS
  Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors.
  
  
  RESULTS
  The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs.
  
  
  CONCLUSIONS
  The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened.
authors.forename: Xiaoxin
authors.initials: X
authors.lastname: Dong
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.forename: Shiyi
authors.initials: S
authors.lastname: Cao
authors.forename: Huajie
authors.initials: H
authors.lastname: Yang
authors.forename: Fujian
authors.initials: F
authors.lastname: Song
authors.forename: Chen
authors.initials: C
authors.lastname: Yang
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Gong
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiaoxu
authors.initials: X
authors.lastname: Yin
authors.forename: Xing
authors.initials: X
authors.lastname: Xu
authors.forename: Jun
authors.initials: J
authors.lastname: Xie
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.affiliation: School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. zuxunlu@yahoo.com.
authors.forename: Zuxun
authors.initials: Z
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000368:Aged; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D002681:China; D003153:Community Health Services / Q000706:statistics & numerical data*; D005260:Female; D006299:Health Services for the Aged; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012737:Sex Factors; D014505:Urban Population; D035862:Vulnerable Populations / Q000706:statistics & numerical data*