China has made remarkable progress in strengthening its primary health-care system.
Nevertheless, the system still faces challenges in structural characteristics, incentives
and policies, and quality of care, all of which diminish its preparedness to care
for a fifth of the world's population, which is ageing and which has a growing prevalence
of chronic non-communicable disease. These challenges include inadequate education
and qualifications of its workforce, ageing and turnover of village doctors, fragmented
health information technology systems, a paucity of digital data on everyday clinical
practice, financial subsidies and incentives that do not encourage cost savings and
good performance, insurance policies that hamper the efficiency of care delivery,
an insufficient quality measurement and improvement system, and poor performance in
the control of risk factors (such as hypertension and diabetes). As China deepens
its health-care reform, it has the opportunity to build an integrated, cooperative
primary health-care system, generating knowledge from practice that can support improvements,
and bolstered by evidence-based performance indicators and incentives.