Analyzing the Effectiveness of Primary Healthcare in China: A Qualitative Comparative Study Using the TOE Framework.

The effectiveness of primary healthcare is a critical element in implementing a tiered medical system. However, substantial disparities exist in the development of primary healthcare systems across different regions. Previous studies have mainly concentrated on describing the present situation, analyzing the causes of problems, and proposing policy suggestions. Nevertheless, they have not fully revealed the intricate operational mechanisms of interrelated factors. Leveraging case studies from 26 cities, we utilized the TOE framework to establish a comprehensive model of factors influencing primary healthcare effectiveness. Employing a fuzzy set qualitative comparison method, we scrutinized essential factors and pathways. We have identified three key paths driving the advancement of advanced primary healthcare. Path 1 is characterized by the level of information, accessibility of primary healthcare institutions, and government attention. Path 2 is associated with government attention and the aging population. Path 3 emphasized the significance of primary healthcare accessibility, level of economic development, and public health demand. These findings provided valuable insights for the enhancement of tiered healthcare in China.