title: Contribution of primary care to health: an individual level analysis from Tibet, China.
abstract: BACKGROUND
  There have been significant improvements in health outcomes in Tibet, health disparities between Tibet and the rest of China has been greatly reduced. This paper tests whether there was a positive association between good primary care and better health outcomes in Tibet.
  
  
  METHODS
  A validated Tibetan version of the Primary Care Assessment Tool (PCAT-T) was used to collect data on 1386 patients aged over 18 years old accessing primary care. Self-rated health (SRH) was employed to measure health outcomes. A multiple binary logistic regression model was used to explore the association between primary care quality and self-rated health status after controlling for socio-demographic and lifestyle variables.
  
  
  RESULTS
  This study found that primary care quality had a significant positive association with self-rated health status. Among the nine domains of PCAT-T, family centeredness domain had the highest Odds Ratio (OR = 1.013) with SRH. Patients located in rural area, with higher education levels, without depression, and less frequent drinking were more likely to self-rate as "good health" compared with the reference group.
  
  
  CONCLUSIONS
  In Tibet, higher quality primary care was associated with better self-rated health status. Primary care should be much strengthened in future health system reform in Tibet.
authors.affiliation: School of Public Health, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei Province, P. R. China. whwang1986@163.com.|Center for Health Management and Policy, Shandong University, 44 Wenhuaxilu, Jinan, 250012, Shandong Province, P. R. China. whwang1986@163.com.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Wang
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Primary Care Policy Center, 624 North Broadway, Baltimore, MD, 21205, USA. lshi@jhsph.edu.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.affiliation: Center for Health Management and Policy, Shandong University, 44 Wenhuaxilu, Jinan, 250012, Shandong Province, P. R. China. yaitian@sdu.edu.cn.
authors.forename: Aitian
authors.initials: A
authors.lastname: Yin
authors.affiliation: School of Public Health, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei Province, P. R. China. zfmao@126.com.
authors.forename: Zongfu
authors.initials: Z
authors.lastname: Mao
authors.affiliation: School of Management, Australian School of Business, University of New South Wales, Sydney, 2052, NSW, Australia. e.maitland@unsw.edu.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Maitland
authors.affiliation: School of Management, Tianjin Normal University, West Bin Shui Avenue, Tianjin, 300074, P. R. China. stephen.nicholas@newcastle.edu.au.|School of International Business, Beijing Foreign Studies University, 19 North Xisanhuan Avenue, Haidian, Beijing, 100089, P. R. China. stephen.nicholas@newcastle.edu.au.|Guangdong Research Institute for International Strategies, Guangdong University of Foreign Studies, 2 Baiyun North Avenue, Baiyun, Guangzhou, 510420, Guangdong, P. R. China. stephen.nicholas@newcastle.edu.au.|University of Newcastle, Newcastle, 2308, NSW, Australia. stephen.nicholas@newcastle.edu.au.
authors.forename: Stephen
authors.initials: S
authors.lastname: Nicholas
authors.affiliation: China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, P. R. China. xliu@bjmu.edu.cn.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D005260:Female; D006262:Health / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010465:Perception; D011320:Primary Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D018609:Tibet