Synergy of policies on interrelated health systems function are warranted to strengthen PHC, especially for low- and middle-income countries (LMICs).

Effective mechanisms for coordination across multisectoral actions are necessities for deepening those policies to ensure efficient delivery of healthcare without experiencing financial risks.Īs Governments strive to progress towards the Sustainable Development Goals including Universal Health Coverage, concerted efforts are being made to strengthen primary healthcare (PHC) so that people have access to quality health services without experiencing financial risks. Primary care strengthening requires synergic policies. The negative impacts of ARR at PHC institutions on likelihood of visiting county-, municipal- and higher-level hospitals in 2013 was 28 percentage points, 66 percentage points and 33 percentage points larger than these in 2008. ResultsĪlthough the increase in health insurance ARR and physician density have positive impacts on individuals’ healthcare use, their impacts might be weakened during 20, and the negative impacts of investment of those in PHC institutions on likelihood of visiting hospitals was larger. We constructed a multilevel zero-inflated negative binomial regression to examine the impacts of average reimbursement rate (ARR) of health insurance and the density of registered physicians on outpatient/inpatient visits, and multilevel multinomial logistic regression for the impacts on choice of outpatient/inpatient care providers. Methodsĭrawing on national survey data before (2008) and after (2013) the policies, we linked individual-level data on healthcare-seeking behavior with county-level data on health workforce and health insurance. This study aimed to assess the impact of the two policy areas, health insurance and health workforce, on healthcare seeking behavior. In 2009, China launched nationwide synergic policies on primary care strengthening, to tackle access to healthcare and financial protection. People bypass primary healthcare (PHC) institutions to seek expensive healthcare at high-level hospitals, leading to escalating medical costs and inefficient use of resources.

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