title: Comparison of Primary Care Experiences in Village Clinics with Different Ownership Models in Guangdong Province, China.
abstract: OBJECTIVE
  In order to improve the quality of services at village clinics (VCs), which are important primary care service providers in rural China, the Chinese government has encouraged the township hospitals to own and manage VCs. There are currently three models of ownership and management of VCs: township hospital-owned and -managed (HVC), village committee-owned and -managed (VVC), and private-owned and -managed (PVC). This study aims to examine the association between these ownership models of VCs and patients' primary care experiences.
  
  
  METHODS
  Villagers were selected by multistage stratified sampling and their experiences with primary care were measured using the Primary Care Assessment Tool-Adult Edition (PCAT-AS). Data were collected through face-to-face interviews and the questionnaires administered by investigators in the cross-sectional study from February to April 2015. The PCAT scores were compared among the three models by covariance analysis, and multiple linear regression was used to analyze factors associated with the PCAT total scores.
  
  
  RESULTS
  A total of 1491 questionnaires were collected. After controlling for covariates, HVCs reported the highest PCAT scores and satisfaction rate. In terms of the domains, HVC reported the highest scores in the coordination and comprehensiveness domains, while PVC had the highest scores in the first contact-accessibility domain. Multivariate linear regression showed that HVC, married participants, aged 60 and older, satisfied with the services, receiving six or more visits, and those with medical expenditures over 20% of their total family expenditures, were also positively associated with better primary care quality.
  
  
  CONCLUSIONS
  This study demonstrates that villagers receiving medical care at HVCs perceived better primary care than those at PVCs and VVCs. In order to improve the quality of primary care at VCs, it is necessary to increase government subsidies for public service packages, tighten the township hospital's supervision of PVCs and VVCs, and develop performance-based incentive plans to motivate improvements in the accessibility of HVCs.
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.|Sun yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.|Faculty of Health Management, School of Health management, Guangzhou Medical University, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Feng
authors.affiliation: Sun yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.|Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.|Sun yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jiazhi
authors.initials: J
authors.lastname: Zeng
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.|Sun yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.|Sun yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.
authors.forename: Li
authors.initials: L
authors.lastname: Ling
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult