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Cross-sectional study of factors associated with community health centre use in a recently urbanised community in Chengdu, China
  1. Danping Liu1,
  2. Hongdao Meng2,
  3. Debra Dobbs2,
  4. Kyaien O Conner3,
  5. Kathryn Hyer2,
  6. Ningxiu Li1,
  7. Xiaohui Ren1,
  8. Bo Gao1
  1. 1Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu, China
  2. 2School of Aging Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA
  3. 3Department of Mental Health Law & Policy, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA
  1. Correspondence to Dr Hongdao Meng; meng{at}usf.edu

Abstract

Objectives Public investment in community health centres (CHCs) has been increasing as a response to rapid urbanisation in China. The objectives of this study were: (1) to examine factors associated with CHC use among residents from a recently urbanised community in western China and (2) to describe satisfaction with CHC among users.

Design Cross-sectional design.

Setting A community recently converted to urban status with a newly constructed CHC in Southwest China.

Participants A random sample of 2259 adults in the Hezuo community in Chengdu, China, completed the survey in 2013.

Outcome measures Trained staff interviewed study participants in their homes using structured questionnaires. The survey included questions regarding sociodemographics, health status, access to and usage of healthcare, health behaviours and CHC use. The Andersen’s behavioural model of health service use was used to guide multivariable logistic regression modelling in identifying predisposing, enabling and need factors associated with the likelihood of using CHC. Descriptive statistics were used to describe residents’ satisfaction with the CHC.

Results A total of 71.8% of the respondents reported using the CHC during the past year. Factors influencing adults’ CHC use included: gender, marital status, education level and knowledge of one’s blood pressure (predisposing factors); annual household per capita income and walking time to the CHC (enabling factors) and self-rated health as well as physical activities (need factors). CHC users reported modest satisfaction across various aspects of the CHC.

Conclusions Neighbourhood CHC in urban areas provides important services to these residents living in a recently urbanised community. All three categories of factors in the Andersen model help explain the likelihood of CHC use. There is much room for improvement in CHC to enhance customer satisfaction. Future research is needed to improve access to CHCs and promote their use in urbanised populations with low to modest education.

  • access to health care
  • health services
  • satisfaction
  • urbanization

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors All authors contributed to the preparation and editing of the manuscript. DL, NL, XR and BG: designed the study, collected the data and conducted the literature review. DL and HM: analysed the data and drafted the manuscript. DD, KOC and KH: contributed to data interpretation and critical revisions of the manuscript.

  • Funding This work was supported by Hezuo Sub'District of Chengdu, China. DL was supported by funding from the China Scholarship Council.

  • Competing interests None declared.

  • Ethics approval Sichuan University Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.

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