Chinese General Practice ›› 2025, Vol. 28 ›› Issue (34): 4300-4310.DOI: 10.12114/j.issn.1007-9572.2023.0911

• Article·Chinese General Practice/Community Health Service • Previous Articles     Next Articles

Exploring the Concept of the Quality of Primary Health Care: a Systematic Review

  

  1. 1 China Center for Health Development Studies, Peking University, Beijing 100191, China
    2 School of Public Health, Peking University, Beijing 100191, China
    3 School of Health Policy & Management, Nanjing Medical University, Nanjing 211166, China
    4 Jiangsu Provincial Institute of Health, Nanjing Medical University, Nanjing 211166, China
  • Received:2024-10-15 Revised:2025-06-23 Published:2025-12-05 Online:2025-10-21
  • Contact: ZHANG Xiaotian, LIU Xiaoyun

基本卫生保健质量概念内涵研究的系统综述

  

  1. 1.100191 北京市,北京大学中国卫生发展研究中心
    2.100191 北京市,北京大学公共卫生学院
    3.211166 江苏省南京市,南京医科大学医政学院
    4.211166 江苏省南京市,南京医科大学江苏省健康研究院
  • 通讯作者: 张笑天, 刘晓云
  • 作者简介:

    作者贡献:

    李明月、刘晓云负责文章的构思设计;李明月负责文献检索、分析、撰写论文并对文章负责;李明月、郑汇娴负责文献筛选与整理;汤皓晴、郑汇娴、张笑天负责对文章提出重要修改意见;刘晓云、张笑天负责文章指导、质量控制与审校。

  • 基金资助:
    国家留学基金委2023年国家建设高水平大学公派研究生项目(202306010282)

Abstract:

Quality of primary health care (PHC), as an important dimension of universal health coverage, is receiving increasing attention globally. A correct understanding of the concept of PHC quality is a prerequisite for measuring, evaluating, and improving quality. PHC quality in China is not clearly defined, and there is no standardized definition and evaluation methodology. Research and policies on PHC quality face enormous challenges. This systematic review searched CNKI, VIP, Wanfang, PubMed, Embase, Google Scholar as well as official websites. Thematic analysis was used for data analysis. After screening, 31 studies/reports covering both low- and middle-income and developed countries were included. The current concepts of PHC quality can be categorized into three themes: (1) content-driven definitions, (2) goals-driven definitions, and (3) characteristics-driven definitions. The content of PHC includes basic medical services, public health services, and quality improvement. The goals of PHC include safety, effectiveness, timeliness, efficiency, equity, appropriateness, patient satisfaction, and patient-centeredness. The characteristics of PHC include access, continuity, coordination, comprehensiveness, family/community-centeredness, and integration. China should define PHC quality combining the content, goals, and characteristics of PHC that considers the stage of economic and social context and health care system context.

Key words: Primary health care, Quality of health, Careconcept, Systematic review

摘要:

质量作为全民健康覆盖的重要维度在国际上受到越来越多的关注。正确理解基本卫生保健质量的概念是其进行测量、评价和改善的前提。目前,我国对基本卫生保健质量的概念界定不清晰,尚未形成统一、标准化的概念和评价体系,基本卫生保健质量的研究和相关政策制定均面临巨大挑战。本研究采用系统综述的方法,检索中国知网、维普网、万方数据知识服务平台、PubMed、Embase、Google Scholar文献数据库以及国内外官方网站,提取资料,采用主题分析法进行资料分析。经过筛选,最终纳入涵盖中低收入国家和发达国家的31篇研究/报告。本研究将目前关于基本卫生保健质量的概念可以归纳为三类:(1)以基本卫生保健内容为导向界定的质量,(2)以基本卫生保健目标为导向界定的质量,(3)以基本卫生保健特征为导向界定的质量。基本卫生保健内容包括基本的医疗卫生服务、公共卫生服务、质量改进;基本卫生保健的目标包括安全、有效、及时、高效、公平、适宜、使患者满意、以患者为中心;基本卫生保健的特征包括可及性、连续性、协调性、综合性、以家庭/社区为单位、整合。我国应结合基本卫生保健的内容、目标及特征,界定适合我国经济社会发展水平和卫生事业发展现状的质量概念。

关键词: 初级卫生保健, 卫生保健质量, 概念, 系统综述