title: Types of health care facilities and the quality of primary care: a study of characteristics and experiences of Chinese patients in Guangdong Province, China.
abstract: In China, most people tend to use hospitals rather than health centers for their primary care generally due to the perception that quality of care provided in the hospital setting is superior to that provided at the health centers. No studies have been conducted in China to compare the quality of primary care provided at different health care settings. The purpose of this study is to compare the quality of primary care provided in different types of health care facilities in China.
  
  
  
  A cross-sectional survey with patients was conducted in Guangdong province of China, using the validated Chinese Primary Care Assessment Tool (PCAT). ANOVA was performed to compare the overall and 10 domains of primary care quality for patients in tertiary, secondary, and primary health care settings. Multivariate analyses were used to assess the association between types of facility and quality of primary care attributes while controlling for sociodemographic and health care characteristics.
  
  
  
  The final number of respondents was 864 including 161 from county hospitals, 190 from rural community health centers (CHCs), 164 from tertiary hospitals, 80 from secondary hospitals, and 269 from urban CHCs. Type of health care facilities was significantly associated with total PCAT score and domain scores. CHC was associated with higher total PCAT score and scores for first contact-access, ongoing care, comprehensiveness-services available, and community orientation than secondary and/or tertiary hospitals, after controlling for patients' demographic and health characteristics. Higher PCAT score was associated with greater satisfaction with primary care received. CHC patients were more likely to report satisfactory experiences compared to patients from secondary and tertiary facilities.
  
  
  
  The study demonstrated that CHCs provided better quality primary care when compared with secondary and tertiary health care facilities, justifying CHCs as a model of primary care delivery.
authors.affiliation: School of Public Health of Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, China.
authors.forename: Ruwei
authors.initials: R
authors.lastname: Hu
authors.affiliation: School of Public Health of Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liao
authors.affiliation: School of Public Health of Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, China.
authors.forename: Zhicheng
authors.initials: Z
authors.lastname: Du
authors.affiliation: School of Public Health of Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, China.
authors.forename: Yuantao
authors.initials: Y
authors.lastname: Hao
authors.affiliation: Johns Hopkins Primary Care Policy Center, Baltimore, 624 N. Broadway, Baltimore, Maryland, 21205, USA.
authors.forename: Hailun
authors.initials: H
authors.lastname: Liang
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, Maryland, 21205, USA. lshi@jhsph.edu.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D003151:Community Health Centers; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012424:Rural Population; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Health policy; Health services development; Health systems; Quality assessment