title: Enhanced Performance of Community Health Service Centers during Medical Reforms in Pudong New District of Shanghai, China: A Longitudinal Survey.
abstract: BACKGROUND
  The performance of community health service centers (CHSCs) has not been well monitored and analysed since China's latest community health reforms in 2009. The aim of the current investigation was to evaluate the performing trends of the CHSCs and to analyze the main factors that could affect the performance in Pudong new district of Shanghai, China.
  
  
  METHODS
  A regional performance assessment indicator system was applied to the evaluation of Pudong CHSCs' performance from 2011 to 2013. All of the data were sorted out by a panel, and analyzed using descriptive statistics and a generalized estimating equation model.
  
  
  RESULTS
  We found that the overall performance increased annually, with a growing number of CHSCs achieving high scores. Significant differences were observed in institutional management, public health services, basic medical services and comprehensive satisfaction during the period of three years. However, we found no differences in the service scores of Chinese traditional medicine (CTM). The investigation also demonstrated that the key factors affecting performance were the location, information system level, family GP program and medical association program rather than the size of the center. However, the medical association participation appeared to have a significant negative effect on performance.
  
  
  CONCLUSIONS
  It can be concluded from the three-year investigation that the overall performance was improved, but that it could have been further enhanced, especially in institutional management and basic medical service; therefore, it is imperative that CHSCs undertake approaches such as optimizing the resource allocation and utilization, reinforcing the establishment of the information system level, extending the family GP program to more local communities, and promoting the medical association initiative.
authors.affiliation: School of Public Health, Public Health Security Key Laboratory of Ministry of Education, Fudan University, Shanghai, China; Pudong Institute for Health Development, Shanghai, China; Health and Family Planning Commission of Pudong new district, Shanghai, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Sun
authors.affiliation: School of Public Health, Public Health Security Key Laboratory of Ministry of Education, Fudan University, Shanghai, China; Pudong Institute for Health Development, Shanghai, China.
authors.forename: Yanting
authors.initials: Y
authors.lastname: Li
authors.affiliation: Pudong Institute for Health Development, Shanghai, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Liu
authors.affiliation: Pudong Institute for Health Development, Shanghai, China.
authors.forename: Jiquan
authors.initials: J
authors.lastname: Lou
authors.affiliation: Pudong Institute for Health Development, Shanghai, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Pudong Institute for Health Development, Shanghai, China; School of Social Development and Public Policy, Fudan University, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Liang
authors.affiliation: Health and Family Planning Commission of Pudong new district, Shanghai, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Gu
authors.affiliation: Pudong Institute for Health Development, Shanghai, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Jing
authors.affiliation: School of Public Health, Public Health Security Key Laboratory of Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Fu
authors.affiliation: Pudong Institute for Health Development, Shanghai, China; School of Social Development and Public Policy, Fudan University, Shanghai, China.
authors.forename: Yimin
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D002681:China; D003151:Community Health Centers / Q000458:organization & administration / Q000592:standards*; D018166:Health Care Reform; D006801:Humans; D008137:Longitudinal Studies; D008962:Models, Theoretical; D017060:Patient Satisfaction / Q000706:statistics & numerical data