Scientific research is a key element of scientific development, which determines the height of that science's development. Research papers published in academic journals are the primary examples of current scientific research results, and analysis of academic journals and publications on a subject can reflect the current development state and trend of scientific research in that science. This paper outlines the trajectory of scientific research in general practice and community health in China, proposes the problems that exist, and provides strategies for improving them througha result of YU Dehua team's bibliometric analysis of papers published in 4 Chinese general practice journals from 2001 to 2020, as well as the Journal of Chinese General Practice research group analyzed papers published by scholars in the field of general practice in 2021. In the future, the scientific research on general practice and community health sciences research can be focused on the following directions: functional positioning and working model of primary medical care, construction of general practice disciplines, collaborative development of regional health, chronic disease management, clinical quality management, primary care and community health service capacity, new models of community health functions oriented to active health, physical and mental care for community populations, training and capacity development of general practitioners, and methodology of scientific research in general practice and community health.
With the deepening of health care reform in China, primary care and general practice researches have developed rapidly in recent years, and the number of papers published has increased rapidly.
Summarize and analyze the scientific research papers published in the field of primary care and general practice in China in 2021, explore the characteristics in the number of papers published, journals published, regions, institutions, research categories, research methods, and the number of authors.
Based on the disciplinary definition of the research concepts, themes and methods in this field, combining scoping review methods and bibliometric techniques, scientific research papers published by researchers in Chinese scientific research institutions in 2021 included in the CNKI, Wanfang, PubMed, and Web of Science database were retried, induced and analyzed. In this paper, combined with the scope review method and bibliometric technology, a systematic search and quantitative analysis were carried out on scientific research papers in the fields of primary care and general practice published by researchers in Chinese scientific research institutions in 2021 included in the CNKI, Wanfang, PubMed, and Web of Science databases.
There are 3 122 original research papers published in the fields of primary care and general practice in China in 2021. The number of papers published by primary care institutions accounted for 57.69%, but most of the papers were completed by a single authoramong such institutions. Papers published by the eastern primary care institutions accounted for 80.12%. The research category is dominated by clinical research (58.23%) and health services researches (27.07%) , the co-occurrence analysis of keywords by VOSviewer shows that the research themes focus on "chronic disease management" and "contracted family doctor services", these papers mostly used randomized controlled trials (40.87%) and cross-sectional survey studies (36.71%) in research methods. The vast majority of papers in primary care and general practice field are published in non-core and non-SCI/SSCI journals (76.75%) , and only 6.98% of papers are published in SCI/SSCI journals.
The productivity level of primary care and general practice research in China has now reached the highest level in the world, of which the primary care institutions in the eastern region have made major contributions. The research topics in the primary care and general practice field are close to institutional practice and national health policy. However, there are still a series of problems and challenges in this field, such as the lack of cooperation among researchers in primary care institutions, the large number of studies using randomized controlled trial methods may have problems such as quality concerns and low recognition of research in this field in China by international SCI/SSCI journals.
To meet the growing healthcare needs of people and requirements of the national healthcare reform, general practice and its service delivery models have been introduced into Chinese mainland, and developed rapidly with the support and promotion of national policies. However, the localization of general practice in China has revealed that the academic discipline development and delivery models of general practice are still immature, and the research content, practice path and research methods regarding general practice need to be further clarified.
To perform a review of the articles published in Chinese general practice journals to assess the academic discipline development, theoretic research and practice status, and focus areas for development regarding general practice, providing evidence for academic discipline development of general medicine in China.
In December 2021, the CNKI database was systematically searched for articles published in four representative Chinese general practice journals (Chinese General Practice, Chinese Journal of General Practitioners, Chinese Journal of General Practice, and Chinese Primary Health Care) from 2001 to 2020, and the official websites of the State Council and the National Health Commission of the People's Republic of China were searched for policy documents about general practice and the reform of the pharmaceutical and healthcare system issued from 1997 to 2020. The themes of policy documents in every five years in the period 2001—2020 were analyzed. And keywords of articles published in every five years in the period 2001—2020 were extracted for word frequency analysis and co-occurrence analysis, and for identification of the burst terms. Then the consistency of research hotspots with the themes of policy documents in every five years during 2001—2020 was assessed.
Altogether, 54 726 articles were included, from which 1 398 keywords were extracted and sorted out, and 62 related policy documents were retrieved. The top 10 keywords in terms of frequency of use were "efficacy" (n=2 998) , "community health service" (n=2 235) , "diabetes" (n=2 004) , "influencing factors" (n=1 586) , "elderly people" (n=1 368) , "diagnosis" (n=1 359) , "hypertension" (n=1 313) , "general practitioner" (n=1 303) , "children" (n=1 302) and "nursing" (n=1 107) . By cluster analysis of key words, the major directions of research on general practice and community health during 2001—2020 were classified into three categories: clinical diagnosis and treatment (involving the efficacy assessment of treatment, nursing, and various laboratory examination methods, and diagnosis and treatment of multiple cancers) , disease management (including the management of various common diseases and frequently-occurring diseases, and most of them are chronic diseases, such as diabetes, hypertension, chronic obstructive pulmonary disease, coronary heart disease, depression, pregnancy complications, and cognitive dysfunction) , and community health services (mainly involving health education, community health, rural health, contracted family doctor services, tiered diagnosis and treatment, and bi-directional referral services) . The analysis of burst terms indicated that the focus of research during 2001—2005 was mainly on clinical analysis and clinical observation of diseases, community health services, township health centers, and rural doctors, and that during 2016—2020 was mainly on the analysis of influencing factors of diseases, tiered diagnosis and treatment, contracted family doctor services and quality of life, which were basically consistent with the requirements of the national policies regarding medical and health development.
The research regarding general practice and community health from 2001 to 2020 in China revealed that general medical services have played an important part in satisfying the needs of basic medical and public health, which cover all population throughout the entire lifecycle, and focus on addressing both somatic or mental health issues. Moreover, the related research hotspots were centered on the application of the biopsychosocial model and people-centered model, and basically targeting the requirements of the national reform of the pharmaceutical and healthcare system. It is recommended to paid more attention to general practice education and the innovation of medical models in future research, so as to promote the sustainable development of general practice.
Scientific research is an important part of discipline construction and a driving force of discipline development. However, there is a lack of systematic analysis of research capacity and quality in the field of general practice and community health in China.
To understand the current situation of China's general practice research capabilities, analyze the existing problems and provide a basis for further improving the research capabilities in the field of general practice and community health in China.
In December 2021, academic papers published from 2001 to 2020 in Chinese General Practice, Journal of General Practitioners, China General Practice, and Primary Health Care in China were retrieved from CNKI platform. The years of 2001—2020 were divided into four time periods, on average of 5 years, and the regional distribution, institution type distribution, investigator cooperation network, and study type distribution of the institutions of the first author of the included articles were bibliometrically analyzed using Vosviewer 1.6.17.
Finally, 54 726 papers were included. From 2001 to 2020, research institutions in East China published the largest number of papers (24 015, 43.88%) , followed by North China (11 288, 20.63%) and South China (5 437, 9.93%) . There was an overall upward trend in the number of publications in community health service centers, which increased from 15 in 2001 (1.31% of the total annual volume) to 203 in 2020 (9.38% of the total annual volume) . A total of 8 collaborative networks emerged from the analysis of co-occurrence among investigators, including the following research teams: Department of General Practice of Zhongshan Hospital, the Journal of Chinese General Practice, and the Capital Medical University. Regarding the types of studies, the percentage of studies in the theoretical class decreased from 28.68% (329/1 147) in 2001 to 17.93% (388/2 164) in 2020; the proportion of intervention type studies gradually increased from 10.11% (116/1 147) in 2001 to 17.28% (374/2 164) in 2020, but its proportion in the overall studies was still low; the percentage of observational studies was the highest, with 64.79% (1 402/2 164) in 2020.
The research in the field of general practice and community health in China has shown a rapid development trend from 2001 to 2020, but there still remain some problems such as unbalanced development of research capabilities, insufficient cooperation and communication of research teams, and insufficient innovation of research methods. It is recommended to further strengthen the construction of domestic scientific research cooperation network and focus on improving the quality of research.
