title: Essential Public Health Services' Accessibility and its Determinants among Adults with Chronic Diseases in China.
abstract: BACKGROUND
  Along with three years implementation of health reform in China, this study aimed at providing the up-to-date evidence about the accessibility of essential public health services (EPHS) among adults with chronic diseases (CDs) in both urban and rural areas, as well as determinants in access to EPHS.
  
  
  METHODS
  The data were collected from a cross-sectional survey conducted in 2013, which used a multistage stratified random sampling method to select 54 urban communities and 54 rural villages. Hypertension patients and diabetes patients were the target population who are the main beneficiaries of EPHS. Single factor analysis of influencing factors on difference access to EPHS was performed by Chi-Square analysis. Logistic regression analysis was used to determine the predictors of effective management and effective control.
  
  
  RESULTS
  Patients with hypertension or diabetes were predominantly middle-aged or older persons and had a mean age of 65.26 year. People with CDs in China have a higher basic accessibility rate in EPHS with more than 90% of them having experience in receiving EPHS. And those who are willing to receive services from doctors have the most positive influence on effective management and control in blood pressure or blood glucose. But unsatisfied quality and equity of EPHS still exist in primary health system. 90% of participants could receive EPHS, but just 44% of them could control their diseases effectively. And participants from cities had the higher rates in effective management (urban: rural = 57%: 50.6%) and effective control (urban: rural = 39.5%: 27.8%).
  
  
  CONCLUSIONS
  People with CDs have a high level in geography and economic accessibility to EPHS, but the effectiveness of health management also needs to be improved, especially for those living in rural areas. Our study highlights the continuing need for improving ability to provide EPHS and the equality among regions. Meanwhile, strengthen health education and promotion for patients with CDs to improve their willingness to receive EPHS is also highlighted.
authors.affiliation: Institute of Medical Information, Center for Health Policy and Management, Chinese Academy of Medical Sciences, Beijing, 100020, China.
authors.forename: Miaomiao
authors.initials: M
authors.lastname: Tian
authors.affiliation: The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Wang
authors.affiliation: Guiyang Medical University, Guiyang, 550004, Guizhou, China.
authors.forename: Xuetao
authors.initials: X
authors.lastname: Tong
authors.affiliation: Institute of Medical Information, Center for Health Policy and Management, Chinese Academy of Medical Sciences, Beijing, 100020, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Institute of Medical Information, Center for Health Policy and Management, Chinese Academy of Medical Sciences, Beijing, 100020, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Zhang
authors.affiliation: School of Management, Jiangsu University, Zhanjiang, 212013, Jiangsu, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D018166:Health Care Reform / Q000458:organization & administration; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012424:Rural Population; D014505:Urban Population