Background
Methods
Data source and sampling
Project quality control
Variables and data analysis
LOWG | HOWG | Total | ||||||
---|---|---|---|---|---|---|---|---|
Categorical variable | Yes | N*(%) | Yes | N* (%) | Yes | N* (%) |
x
2
| p |
1. Policy and Management
| ||||||||
1.1 Whether HC is a unit of corporate sole | 890 | (71.95) | 269 | (48.64) | 1159 | (64.75) | 90.9316 | <0001 |
1.2 Whether separate management of income and expenditure in two lines | 430 | (34.76) | 154 | (27.85) | 584 | (32.63) | 8.3095 | 0.0039 |
1.3 Whether all-staff employment management | 1009 | (81.57) | 465 | (84.09) | 1474 | (82.35) | 1.6674 | 0.1966 |
1.4 Ownership of HC (total) | 1237 | (100) | 553 | (100) | 1790 | (100) | ||
Government-owned HC | 915 | (73.97) | 466 | (84.27) | 1381 | (77.15) | 24.2437 | <0001 |
Enterprise-owned HC | 235 | (19.00) | 59 | (10.67) | 294 | (16.42) | ||
Private HC | 55 | (4.45) | 20 | (3.62) | 75 | (4.19) | ||
Other holder-owned HC | 32 | (2.59) | 8 | (1.45) | 40 | (2.23) | ||
1.5 HC designated by health insurance (total) | 1237 | (100) | 553 | (100) | 1790 | (100) | ||
Not designated by health insurance | 553 | (44.7) | 164 | (29.66) | 717 | (40.06) | 123.7698 | <0001 |
Outpatient designated | 348 | (28.13) | 302 | (54.61) | 650 | (36.31) | ||
Inpatient designated | 38 | (3.07) | 21 | (3.8) | 59 | (3.30) | ||
Both outpatient and inpatient designated | 298 | (24.09) | 66 | (11.93) | 364 | (20.34) | ||
1.6 Whether HC owns the house (total) | 1237 | (100) | 553 | (100) | 1790 | (100) | ||
House is used for free | 344 | (27.81) | 184 | (33.27) | 528 | (29.5) | 40.499 | <0001 |
House is owned by HC | 538 | (43.49) | 154 | (27.85) | 692 | 692 (38.66) | ||
House is rented by HC | 355 | 355 (28.7) | 215 | (38.88) | 570 | (31.84) | ||
1.7 How HC pays for the rented house (total) | 892 | (100) | 369 | (100) | 1262 | (100) | ||
Rent subsidised by the government | 223 | (24.97) | 89 | (24.12) | 312 | (24.72) | 12.3449 | 0.0063 |
Rent partly subsidised by the government | 144 | (16.13) | 41 | (11.11) | 185 | (14.66) | ||
Rent self-raised | 432 | (48.38) | 213 | (57.72) | 645 | 645 (51.11) | ||
Rent paid by other sources | 94 | (10.53) | 26 | (7.05) | 120 | 120 (9.51) | ||
4. Quality of care
| ||||||||
4.1 Facilities
| ||||||||
4.1.1 HC with Chinese medicine department | 1008 | (81.49) | 396 | (71.61) | 1404 | (78.44) | 22.0464 | <0001 |
4.1.2 HC with Chinese medicine dispensary | 882 | 882 (71.3) | 337 | (60.94) | 1219 | 1219 (68.1) | 18.8855 | <0001 |
4.1.3 HC with medical equipment #
| ||||||||
With rehabilitation physiotherapy facilities | 932 | (75.34) | 453 | (81.92) | 1385 | (77.37) | 9.432 | 0.0021 |
With electrocardiogram machine | 1174 | (94.91) | 534 | (96.56) | 1708 | (95.42) | 2.4009 | 0.1213 |
With blood sugar instrument | 1144 | (92.48) | 519 | (93.85) | 1663 | (92.91) | 1.088 | 0.2969 |
With biochemistry analysis instrument | 930 | (75.18) | 399 | (72.15) | 1329 | (74.25) | 1.8349 | 0.1756 |
With B ultrasound instrument | 1052 | (85.04) | 456 | (82.46) | 1508 | (84.25) | 1.9243 | 0.1654 |
With centrifugal machine | 849 | (68.63) | 356 | (64.38) | 1205 | (67.32) | 3.1488 | 0.076 |
With X ray machine | 879 | (71.06) | 290 | (52.44) | 1169 | 1169 (65.31) | 58.4652 | <0001 |
HOWG | HOWG | |||
---|---|---|---|---|
Numerical variable | Mean ± Std | Mean ± Std | t | p |
1. Policy and Management
| ||||
1.1 Management between HC and HS | ||||
HS owned by HC | 1.83 ± 3.24 | 1.68 ± 3.44 | 0.92 | 0.3597 |
HS not owned by HC but receiving HC guide | 1.18 ± 4.75 | 0.54 ± 2.55 | 3.72 | 0.0002 |
2. Financing
| ||||
2.1 Percentage of treatment income in total income (%) | 22.11 ± 17.78 | 26.00 ± 17.29 | -4.32 | <0001 |
2.2 Percentage of drug income in total income (%) | 39.47 ± 21.76 | 39.17 ± 20.00 | 0.29 | 0.7745 |
2.3 Percentage of fiscal income in total income (%) | 23.42 ± 24.57 | 18.43 ± 18.43 | 4.75 | <0001 |
2.4 Percentage of health insurance in total income (%) | 9.46 ± 14.36 | 12.50 ± 14.73 | -4.1 | <0001 |
3. Continuum of care
| ||||
3.1 Demographic characteristics of population served
| ||||
3.1.1 Percentage of the population above 60 in total population (%) | 11.09 ± 7.83 | 7.80 ± 7.55 | 8.31 | <0001 |
3.1.2 Percentage of children aged in 0 to 6 in total population (%) | 3.85 ± 3.30 | 4.20 ± 4.11 | -1.75 | 0.0807 |
3.1.3 Percentage of baby aged in 0 to 1 in total population (%) | 0.78 ± 1.06 | 0.97 ± 1.27 | -3.09 | 0.0021 |
3.1.4 Percentage of pregnant women in total population (%) | 0.71 ± 1.79 | 0.60 ± 0.79 | 1.79 | 0.0743 |
3.1.5 Percentage of alive newborn baby in total population (%) | 0.61 ± 1.38 | 0.54 ± 0.57 | 1.54 | 0.1242 |
3.1.6 Percentage of women in childbearing age in total population (%) | 21.48 ± 13.45 | 27.96 ± 19.15 | -7.18 | <0001 |
3.1.7 Percentage of mental patient in total population (%) | 0.21 ± 1.03 | 0.15 ± 0.40 | 1.74 | 0.0824 |
3.1.8 Percentage of disabled patient in total population (%) | 1.10 ± 1.54 | 0.66 ± 1.04 | 7.18 | <0001 |
3.1.9 Percentage of people with pension in total population (%) | 1.92 ± 2.81 | 1.05 ± 2.54 | 6.49 | <0001 |
3.2 Referral
| ||||
3.2.1 Patients referred to the upper level institutions | 132.68 ± 591.09 | 445.68 ± 1742.78 | -4.12 | <0001 |
3.2.2 Patients referred to the lower level institutions | 40.38 ± 215.17 | 123.29 ± 577.65 | -3.28 | 0.0011 |
4. Quality of care
| ||||
4.1 Facilities
| ||||
4.1.1 Fixed asset owned by the HC (10,000 yuan) | 433.86 ± 879.91 | 342.02 ± 776.69 | 2.22 | 0.0268 |
4.1.2 Area of HC house ( M2) | 2176.22 ± 2733.49 | 1647.48 ± 1941.14 | 4.66 | <0001 |
4.1.3 Drug kinds | ||||
West medicine | 359.68 ± 296.29 | 392.08 ± 562.53 | -1.28 | 0.2018 |
Chinese patent medicine | 148.31 ± 126.51 | 157.05 ± 273.01 | -0.72 | 0.4723 |
4.1.4 Beds | ||||
Current inpatient bed | 28.94 ± 44.47 | 15.59 ± 29.40 | 7.51 | <0001 |
Current observation bed | 0.52 ± 1.12 | 0.51 ± 1.00 | 0.21 | 0.8349 |
4.2 Human resources
| ||||
4.2.1 Total member of current staff | 56.49 ± 93.93 | 42.33 ± 49.87 | 4.15 | <0001 |
Temporary member of staff` | 12.41 ± 18.39 | 14.90 ± 18.60 | -2.64 | 0.0084 |
4.2.2 Total member of health technicians | 43.84 ± 44.68 | 32.56 ± 35.84 | 5.68 | <0001 |
Clinical doctor | 19.44 ± 20.77 | 13.07 ± 14.53 | 7.43 | <0001 |
Dentist | 1.12 ± 1.86 | 0.99 ± 1.80 | 1.43 | 0.1519 |
4.2.3 Physician with education certificate | 20.70 ± 24.08 | 15.25 ± 16.69 | 5.53 | <0001 |
Physician with postgraduate certificate | 0.29 ± 1.36 | 0.35 ± 1.59 | -0.71 | 0.4781 |
Physician with undergraduate certificate | 6.68 ± 11.72 | 5.05 ± 7.55 | 3.53 | 0.0004 |
Physician with 3-year education certificate | 8.05 ± 9.50 | 5.88 ± 6.66 | 5.55 | <0001 |
Physician with 2-year education certificate | 4.68 ± 7.03 | 3.38 ± 4.86 | 4.53 | <0001 |
Physician with less than two year education certificate | 0.98 ± 3.51 | 0.59 ± 1.94 | 3.06 | 0.0023 |
4.2.4 New physician enrolled into in 3 year | 2.94 ± 5.88 | 3.00 ± 4.09 | -0.25 | 0.8017 |
New physician with postgraduate certificate | 0.08 ± 0.66 | 0.09 ± 0.38 | -0.58 | 0.5635 |
New physician with undergraduate certificate | 1.45 ± 4.08 | 1.22 ± 2.14 | 1.57 | 0.1172 |
New physician with 3-year education certificate | 1.05 ± 2.20 | 1.25 ± 2.21 | -1.77 | 0.0774 |
New physician with 2-year education certificate | 0.32 ± 1.18 | 0.40 ± 1.07 | -1.33 | 0.1835 |
New physician less than 2 years education certificate | 0.05 ± 0.88 | 0.05 ± 0.42 | -0.09 | 0.9289 |
4.2.5 Nurse with education certificate | 13.44 ± 16.88 | 9.68 ± 11.32 | 5.53 | <0001 |
Nurse with postgraduate certificate | 0.02 ± 0.40 | 0.00 ± 0.06 | 1.41 | 0.1595 |
Nurse with undergraduate certificate | 0.48 ± 1.41 | 0.46 ± 1.90 | 0.22 | 0.8238 |
Nurse with 3-year education certificate | 4.80 ± 7.58 | 3.24 ± 5.18 | 5.08 | <0001 |
Nurse with 2-year education certificate | 7.36 ± 9.57 | 5.65 ± 6.46 | 4.44 | <0001 |
Nurse with less than 2 years education certificate | 0.78 ± 2.59 | 0.33 ± 1.17 | 4.99 | <0001 |
4.2.6 Family medicine and community nursing training | ||||
Physician receiving family medicine guideline training | 1.70 ± 5.66 | 1.54 ± 4.75 | 0.63 | 0.5281 |
Physician receiving the family medicine training | 8.04 ± 9.87 | 7.68 ± 9.74 | 0.71 | 0.4749 |
Nurse receiving the community nursing training | 6.20 ± 9.19 | 5.79 ± 7.87 | 0.96 | 0.3364 |
Staff passing the national middle technical qualification examination | 1.18 ± 4.17 | 1.21 ± 3.82 | -0.14 | 0.8857 |
Results
The comparison between the two groups of HCs for categorical indicators
The comparison between the two groups of HCs in numerical indicators
The results of the logistic regression analysis
Variables | Estimate (b) | Standard Error | Chi-Square | Pr > ChiSq | OR | 95% Wald CL (LL-HL) | |
---|---|---|---|---|---|---|---|
Intercept | -1.5183 | 0.2507 | 36.6908 | <0001 | |||
Patient referred to the upper level institutions |
0.7116
| 0.1522 | 21.8706 | <0001 |
2.037
| 1.512 | 2.745 |
HC is owned by the government |
0.7001
| 0.1608 | 18.9623 | <0001 |
2.014
| 1.47 | 2.76 |
New physician with postgraduate certificate |
0.6541
| 0.2579 | 6.4339 | 0.0112 |
1.923
| 1.16 | 3.189 |
Total member of current staff |
0.4558
| 0.2226 | 4.1908 | 0.0406 |
1.577
| 1.02 | 2.44 |
Nurse receiving the community nursing training |
0.4447
| 0.1866 | 5.6811 | 0.0171 |
1.56
| 1.082 | 2.249 |
Biochemistry analysis instrument |
0.4384
| 0.1571 | 7.7855 | 0.0053 |
1.55
| 1.139 | 2.109 |
Dentist |
0.3835
| 0.1632 | 5.5232 | 0.0188 |
1.467
| 1.066 | 2.02 |
Temporary member of staff |
0.3596
| 0.1451 | 6.1453 | 0.0132 |
1.433
| 1.078 | 1.904 |
Percentage of health insurance in total income |
0.3162
| 0.1588 | 3.9653 | 0.0464 |
1.372
| 1.005 | 1.873 |
Rehabilitation physiotherapy facilities |
0.3115
| 0.1538 | 4.1023 | 0.0428 |
1.365
| 1.01 | 1.846 |
Percentage of women in childbearing age in total population served |
0.2457
| 0.1245 | 3.8933 | 0.0485 |
1.278
| 1.002 | 1.632 |
Physician with 2-year education certificate | -0.2372 | 0.1579 | 2.2569 | 0.133 | 0.789 | 0.579 | 1.075 |
Percentage of pregnant women in total population served | -0.2762 | 0.1356 | 4.1501 | 0.0416 | 0.759 | 0.582 | 0.99 |
House is owned by HC | -0.2815 | 0.1302 | 4.6745 | 0.0306 | 0.755 | 0.585 | 0.974 |
HS not owned by HC, but receiving HC guide | -0.3375 | 0.1514 | 4.9696 | 0.0258 | 0.714 | 0.53 | 0.96 |
Nurse with 3-year education certificate | -0.3387 | 0.1686 | 4.0377 | 0.0445 | 0.713 | 0.512 | 0.992 |
Physician with less than two year education certificate | -0.3498 | 0.1588 | 4.8493 | 0.0277 | 0.705 | 0.516 | 0.962 |
HC is a unit of corporate sole | -0.4391 | 0.1478 | 8.8288 | 0.003 | 0.645 | 0.483 | 0.861 |
Nurse with 2-year education certificate | -0.48 | 0.161 | 8.8829 | 0.0029 | 0.619 | 0.451 | 0.848 |
Percentage of people with pension in total population served | -0.5643 | 0.144 | 15.3659 | <0001 | 0.569 | 0.429 | 0.754 |
Percentage of fiscal income in total income | -0.6278 | 0.1382 | 20.6426 | <0001 | 0.534 | 0.407 | 0.7 |
Both the outpatient and inpatient are designated | -0.6308 | 0.2112 | 8.9166 | 0.0028 | 0.532 | 0.352 | 0.805 |
Clinical doctors | -0.9034 | 0.2118 | 18.1933 | <0001 | 0.405 | 0.268 | 0.614 |