Changes in primary health care service experiences and urban–suburban disparities among Shanghai residents: a two-year comparative study

作者：Sen Yang, Wanyu Li, Shi Jian-wei, Leiyu Shi, Le Ma, Ying Pan, Yang Wang, Chao Gu, Zhang Hanzhi, Guo Mengruo, Hua Jin, Dehua Yu · 发表于：International Journal for Equity in Health · 年份：2025 · DOI：10.1186/s12939-025-02633-w · 被引用次数：4 · 研究领域：Healthcare Systems and Reforms、Primary Care and Health Outcomes、Chronic Disease Management Strategies

BACKGROUND: Primary health care (PHC) is central to achieving universal health coverage, yet longitudinal assessments of residents' experiences-especially regarding urban-suburban disparities-remain scarce. This study aims to examine changes in PHC service experiences among Shanghai residents between 2023 and 2024, identify urban-suburban differences, and explore key influencing factors. METHODS: A two-wave cross-sectional survey was conducted at 248 community health centers in Shanghai from May to June in 2023 and 2024. The Chinese version of the Primary Care Assessment Tool-Adult Short Version (PCAT-AS) was used. Propensity score matching ensured comparability between survey waves. Descriptive statistics, hypothesis testing, and multiple linear regression were employed to assess temporal changes, regional disparities, and associated predictors. RESULTS: Residents reported significantly improved PHC experiences in 2024 across all domains (P < 0.001), with the largest gains in service comprehensiveness (+ 0.23) and referral coordination (+ 0.18). Urban residents consistently reported better experiences in continuity, service delivery, and cultural competence, while suburban residents rated higher in first-contact accessibility and service availability. Improvements from 2023 to 2024 were most notable in first-contact accessibility (Δ = +0.11) and comprehensiveness (Δ = +0.10), though domains such as family-centeredness and cultural competence showed limited progress (Δ = +0.0...