General practitioners with sub-specialties can not only provide high-quality general medical services, but also provide a certain depth of specialized medical services. The combination of general practitioners with sub-specialties of different specialties can provide relatively comprehensive and certain depth of basic medical services for residents in their jurisdictions. Under the situation that the professional service capacity of mental health cannot meet the needs of residents, the necessity of encouraging some general practitioners to develop mental health subspecialties has become increasingly prominent. This article analyzes the necessity of training general practitioners with psychosis subspecialty, the advantages of developing psychosis subspecialty among general practitioners, the obstacles to promoting the development of psychosis sub-expertise of general practitioners in primary care are proposed: the construction of general practitioners training bases for psychosis sub-expertise, the learning platform for general practitioners with psychosis sub-expertise was expanded, construction of sub-specialty teachers of psychosis, policy and financial support, salary and promotion incentive policies, etc., are expected to help general practitioners develop psychosis sub-expertise.
Rare diseases, characterized by low prevalence and significant challenges in diagnosis and management, have increasingly gained attention in recent years due to advancements in medical technology. As gatekeepers of health and managers of patient and family health, general practitioners in many countries are now being integrated into the framework for managing rare diseases. The article discusses the current status of general practitioners in the diagnosis and management of rare diseases, including their role in the management process, efforts made, and the lack of knowledge about rare diseases. It highlights that despite challenges in recognizing rare diseases, most general practitioners are willing to improve their awareness and training. They can effectively participate in the comprehensive management of patients with rare diseases, playing a vital role in early identification, coordinating treatment, and providing integrated services.
Patients' experience as an important aspect of measuring and evaluating the quality of primary healthcare services, it's important to measure and evaluate it. However, the research about patients' experience in China started late, and there are even fewer studies focusing about patients who visit to the primary health care institutions.
To reflect the progress of primary healthcare services in China by measuring and evaluating patients' experience which from the primary health care institutions.
From March to April 2023, a patient questionnaire survey was conducted by trained and qualified investigators using an intercept method on patients of township health centers/community health service centers in 3 sample townships/streets in 12 national comprehensive primary health care pilot zones (hereinafter referred to as "the pilot zones"). The main survey tool was the Assessment Survey of Primary Care (ASPC) scale. In fact, 36 institutions and 1 157 patients were surveyed.
The scores for the dimensions of the first visit/first line care, service accessibility, continuity of the patient relationship, comprehensive services, and coordinated services for the patients surveyed who received primary healthcare services were (69.5±20.5), (74.1±20.1), (72.0±20.7), (75.1±21.0), and (68.5±21.7) respectively, with the total score of the ASPC scale being (71.8±17.3). There were statistically significant differences (P<0.05) between patients of different ages, literacy levels, employment statuses, whether they were signed up or not with prationers, and whether they were with chronic diseases as well as in the different pilot zones in all dimension scores and in total scores. The results of the multivariate linear regression analysis show that age, employment statuses, signed up or not with prationers, and different pilot zones are the influencing factors for the scores of the first visit/first line care in patient (P<0.05), while employment statuses, signed up or not with prationers and different pilot zones are the influencing factors for the scores of the other four dimensions and the total score of the scale (P<0.05). After adjusting for other factors, the scores on the five dimensions and the total score of the ASPC scale were all lower in unemployed patients than in employed patients (P<0.05). The scores on the five dimensions and the total score of the ASPC scale were all higher in patients who had signed up with prationers than in those who had not (P<0.05). The total score of the ASPC scale was higher in patients from Changting County, Xishui County than in those from Jiexiu City (P<0.05), while it was lower in patients from Haiyan County, Lu County, Dongfang City than in those from Jiexiu City (P<0.05). The total score of the ASPC scale was not statistically significant in patients from Suixi County, Shouguang City, Jiaxian County, Xinyuan County, Miyun District, and Shangsi County compared with those from Jiexiu City (P>0.05) .
The scores of ASPC reflect the current situation of primary health care services in China. The implementation of the family doctor contract service enhances the patient's experience of the first visit to the primary health care institutions, accessibility of services, continuity of the doctor-patient relationship, comprehensive services, and coordinated services. The capacity and quality of primary health service delivery varies across the pilot zones. The difference in the experience score of primary outpatients in different experimental areas is related to "patient-centered" and convenience measures.
General practitioners of traditional Chinese medicine (TCM), known as the "gatekeepers" of residents' health, provide continuous services to them. Recently, China has rolled out a series of policies aimed at supporting the growth of the workforce of TCM general practitioners and has made it a key development indicator, which holds great importance for advancing the TCM cause.
In alignment with the development goals outlined in the "14th Five-Year Plan" for the Development of TCM, this study analyzes the current status of the TCM general practitioner workforce in China, explores the optimization of statistical methodologies for TCM general practitioners, and proposes corresponding countermeasures and suggestions.
Based on data from the China Health Statistics Yearbook from 2021 to 2023 and special survey data, the difference between the actual number of TCM general practitioners in 2020 and 2022 and the planned number for 2025 was calculated. The completion rate of the planning targets was then computed based on these differences. A comparative method was used to analyze the data.
In 2022, the number of TCM general practitioners per 10 000 population was 0.75, representing an increase of 13.27% compared to 2020, with an average annual growth rate of 6.43%. There were significant regional disparities in the distribution of TCM general practitioners per 10 000 population, with the eastern, central, and western regions decreasing in that order, at 0.88, 0.68, and 0.61 respectively. The national completion rate for the TCM general practitioner workforce plan was 66.76%, indicating good overall progress. A total of 17 provinces (municipalities, autonomous regions) achieved a completion rate of 40% or higher for their TCM general practitioner workforce planning targets, with 11 of them exceeding their targets. Additionally, 14 provinces (municipalities, autonomous regions) made slower progress, including 9 provinces where the completion rate was negative. Based on special assessment data, calculations were made for TCM general practitioners from the perspectives of functional positioning and scope of practice, with 9 provinces and 20 provinces achieving their planning targets ahead of schedule, respectively.
Currently, the statistical count of TCM general practitioners is directly influenced by the number of general practitioners, leading to significant impacts on the count of TCM general practitioners when there are changes in the statistical criteria for general practitioners. It is necessary to further clarify the definition and statistical scope of TCM general practitioners, and strengthen the monitoring and evaluation of TCM general practitioner indicators to ensure the smooth achievement of planning targets.
