Quality analysis and policy recommendations on the utilization of community basic public health services in urban and suburban Shanghai from 2009 to 2014

Abstract

Disparities in quality of basic public health services exist between urban and rural populations, but there is no data about these disparities between urban and suburban populations in Shanghai. The study aims to analyze and compare the quality of basic public health service utilization of community health service centers in Shanghai urban and suburban areas between 2009 and 2014. This was a cross-sectional study. Using a two-stage random sampling method, 80 community health service centers were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistical analysis, principal component analysis, and forecast analysis were used to compare and analyze basic health services utilization quality between urban and suburban centers. During the 6 years, there has been an increasing trend of the basic public health service effectiveness of prevention services, health care services, rehabilitation services, health education services, and health indexes in Shanghai urban and suburban areas. Prevention services, health care services, health education services, and population health index indicators of urban areas were better than those of the suburbs, while effectiveness indicators of rehabilitation services were lower than that of the suburbs. The urban areas had four principal component scores lower than the suburbs (P < 0.001, P = 0.006, P < 0.001, and P = 0.015). During the 6 years, with the strengthening of national support, basic public health service utilization has increased rapidly, and effectiveness of services has improved obviously. Nevertheless, there is an imbalance of basic public health service utilization between urban and suburban areas.