Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city

Background: Since the new medical reform, remarkable progress was achieved in primary care facilities in the number of consultations and essential public health service program. However, the problems including low quality and high mobility of personnel, weakened capacity and low efficiency of servic...

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Main Authors: Siyuan Wang, Ranfeng Hang, Yingjue Wei, Jianying Liu, Wuxiang Shi, Zhaoquan Huang
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2024-04-01
Series:Chinese General Practice Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950559324000087
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author Siyuan Wang
Ranfeng Hang
Yingjue Wei
Jianying Liu
Wuxiang Shi
Zhaoquan Huang
author_facet Siyuan Wang
Ranfeng Hang
Yingjue Wei
Jianying Liu
Wuxiang Shi
Zhaoquan Huang
author_sort Siyuan Wang
collection DOAJ
description Background: Since the new medical reform, remarkable progress was achieved in primary care facilities in the number of consultations and essential public health service program. However, the problems including low quality and high mobility of personnel, weakened capacity and low efficiency of service still remain. Therefore, it has become an urgent task to solve the dilemma in primary care facility development. Objective: To analyze the development dilemma of primary care facilities and propose corresponding countermeasures. Methods: From April to May 2021 the managers of 16 primary care facilities in 6 counties and 2 districts in Guilin were selected using multi-stage sampling method and invited to attend semi-structured interviews, which main contents included resource allocation, service capacity building, health insurance policy implementation, and development dilemmas. Grounded theory method was applied to classify, summarize and refine the original interview data at each level by NVivo 11.0 software. Results: A total of 38 initial concepts, 9 initial categories, 4 main categories, and 1 core category were extracted, and nodes of stagnation in four dimensions including ''Constraints in Resource Allocation,'' ''Deviation in Functional Positioning,'' ''Obstacles in the approach of the joint reform of 3Ms(medical service system, medical security system and medicine system),'' and ''Lack of Cohesion in Hospital Group Construction'' were obtained. Conclusion: The development of primary care facilities is constrained by a variety of factors, with resource allocation balance and compensation mechanism improvement as core issue, ''approach of the joint reform of 3Ms'' as an external condition, ''adjustment of functional positioning''(adjustment of functional positioning of primary care facilities) as key link, and the construction of cohesion hospital group as important approach.
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spelling doaj-art-4e80d25188ae40379aa2260256aefe812025-08-20T02:06:08ZengKeAi Communications Co., Ltd.Chinese General Practice Journal2950-55932024-04-0111111710.1016/j.cgpj.2024.03.008Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin citySiyuan Wang0Ranfeng Hang1Yingjue Wei2Jianying Liu3Wuxiang Shi4Zhaoquan Huang5School of Public Health, Guilin Medical University, Guilin, ChinaSchool of Public Health, Guilin Medical University, Guilin, ChinaCollege of Humanities and Management Sciences, Guilin Medical University, Guilin, ChinaLabor Union, Guilin Medical University, Guilin, ChinaCollege of Humanities and Management Sciences, Guilin Medical University, Guilin, ChinaParty Committee Office, Guangxi Medical University, Nanning, China; Corresponding author.Background: Since the new medical reform, remarkable progress was achieved in primary care facilities in the number of consultations and essential public health service program. However, the problems including low quality and high mobility of personnel, weakened capacity and low efficiency of service still remain. Therefore, it has become an urgent task to solve the dilemma in primary care facility development. Objective: To analyze the development dilemma of primary care facilities and propose corresponding countermeasures. Methods: From April to May 2021 the managers of 16 primary care facilities in 6 counties and 2 districts in Guilin were selected using multi-stage sampling method and invited to attend semi-structured interviews, which main contents included resource allocation, service capacity building, health insurance policy implementation, and development dilemmas. Grounded theory method was applied to classify, summarize and refine the original interview data at each level by NVivo 11.0 software. Results: A total of 38 initial concepts, 9 initial categories, 4 main categories, and 1 core category were extracted, and nodes of stagnation in four dimensions including ''Constraints in Resource Allocation,'' ''Deviation in Functional Positioning,'' ''Obstacles in the approach of the joint reform of 3Ms(medical service system, medical security system and medicine system),'' and ''Lack of Cohesion in Hospital Group Construction'' were obtained. Conclusion: The development of primary care facilities is constrained by a variety of factors, with resource allocation balance and compensation mechanism improvement as core issue, ''approach of the joint reform of 3Ms'' as an external condition, ''adjustment of functional positioning''(adjustment of functional positioning of primary care facilities) as key link, and the construction of cohesion hospital group as important approach.http://www.sciencedirect.com/science/article/pii/S2950559324000087Primary health care institutions;Development status;Resource allocation;Service ability;Compensation mechanism;Medical alliance;Qualitative research
spellingShingle Siyuan Wang
Ranfeng Hang
Yingjue Wei
Jianying Liu
Wuxiang Shi
Zhaoquan Huang
Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city
Chinese General Practice Journal
Primary health care institutions;Development status;Resource allocation;Service ability;Compensation mechanism;Medical alliance;Qualitative research
title Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city
title_full Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city
title_fullStr Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city
title_full_unstemmed Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city
title_short Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city
title_sort dilemma in primary care facility development a qualitative study based on grounded theory in guilin city
topic Primary health care institutions;Development status;Resource allocation;Service ability;Compensation mechanism;Medical alliance;Qualitative research
url http://www.sciencedirect.com/science/article/pii/S2950559324000087
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