title: Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example.
abstract: BACKGROUND
  To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors' basic public health services provision and to formulate targeted interventions in rural China.
  
  
  METHODS
  Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models.
  
  
  RESULTS
  The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2% among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937-7.678, and OR = 4.027, 95% CI: 1.722-9.420), being under integrated management (OR = 1.978, 95% CI: 1.132-3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95% CI: 1.187-3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100).
  
  
  CONCLUSIONS
  Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.
authors: School of Public Health of Peking University, 38 Xueyuan Road, Haidian District, Beijing, P. R. China. litongtongpku@163.com.
authors: Tongtong
authors: T
authors: Li
authors: School of Public Health of Columbia University, New York, USA. tl2635@cumc.columbia.edu.
authors: Trudy
authors: T
authors: Lei
authors: School of Public Health of Peking University, 38 Xueyuan Road, Haidian District, Beijing, P. R. China. xiezheng@bjmu.edu.cn.
authors: Zheng
authors: Z
authors: Xie
authors: School of Public Health of Peking University, 38 Xueyuan Road, Haidian District, Beijing, P. R. China. tzhang@bjmu.edu.cn.
authors: Tuohong
authors: T
authors: Zhang
mesh_terms: D000328:Adult; D002681:China; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D014481:United States