The status and challenges of primary health care in China^☆

Abstract

This article systematically reviews the development of primary healthcare (PHC) in China over the past 45 years, using data from the “China Health Statistics Yearbook” for 2010-2012, the "China Health and Family Planning Statistics Yearbook" for 2013-2017, and the "China Health Statistics Yearbook" for 2018-2022, along with 2023 World Bank data on infant mortality rate, maternal mortality rate, and average life expectancy for China and upper middle income countries. The development of PHC in China is divided into four stages, and the achievements included the gradual improvement of the PHC network, universal coverage of basic medical insurance, and the expansion of basic public health services in scope and funding. There has been a steady increase in family doctor contracting percentages and continuous improvement in the health status of women and children, ranking key health indicators of China among the top of upper-middle-income countries. Current challenges include imbalanced infrastructure development in PHC, a declining proportion of medical insurance funds, lack of vitality in operational mechanisms, and low salary levels and imperfect incentive system. This paper summarizes the international experience relevant to primary health care and proposes future development strategies in China.

Keywords

Primary health care / General practitioners / Universal health coverage / Universal health care

Declarations

Not applicable.

Authors' contributions

Conceptualization, Q.J.; Writing—original draft, Q.J.; Writing—review and editing, Q.J., Z.Y. and Z.L. All authors have read and agreed to the published version of the manuscript.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Authors' other information

Not applicable.

Declaration of competing interest

The authors declare that they have no competing interests.

Acknowledgements

Not applicable.

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