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In this commentary, we elucidate two distinctive characteristics of China's primary health care system relative to the global primary health care framework: a more narrowly defined patient population and scope of services, along with a diminished clinical capacity in primary care. Building upon this foundation, we critically examine and juxtapose the two quintessential theoretical-practical models of the 20th century that are intimately linked with the integration of medication and prevention. They are the "Community-Oriented Primary Care" Model and the "Barefoot Doctor" Model. Additionally, leveraging a series of practical cases observed within Shanghai's primary care settings in the fourth quarter of 2023, we deliberate on viable approaches for adapting and applying these models in China's primary care infrastructure. We further delineate the requisite external conditions for such a transformation and offer targeted recommendations for the deployment of these models across diverse locales.

Background Addressing current health challenges requires the integrated and continuous health care services. The collaboration between primary care providers (PCPs) and medical specialists other than general practice is the most common means of achieving this objective. The patterns and effect of collaborative working between different disciplines has a direct impact on the quality of integrated service delivery, which is critical to improving patient health outcomes. Objective To systematically review the characteristics of studies related to collaboration patterns between PCPs and medical specialists, contents of collaboration patterns and effects reported by the authors by using scoping review methods. Methods On September 3 in 2022, PubMed, EmBase, Web of Science, CNKI, and Wanfang Data Knowledge Service Platform were searched for literature related to collaboration between PCPs and medical specialists from inception to the date of search. The characteristics of literature, collaboration patterns and effects were extracted. The elemental decomposition of collaboration patterns was performed based on Mulave 'Gearing Up' model and the contents of collaboration patterns were integrated and demonstrated using content analysis method. Results A total of 420 relevant papers were included, of which 214 (51.0%) were committed to evaluating the effects of collaboration patterns, but specific contents of collaboration patterns could be extracted from 82 (19.5%) papers. The distinctive characteristics revealed by the extraction of limited information on the details of collaboration patterns included clear and formalized collaboration patterns, evidence-based guidelines/norms support for collaborative service contents, information systems and dedicated coordinators support for the collaboration between PCPs and specialists. Among the 82 papers, a total of 54 (65.9%) papers clearly reported indicators of effect, of which 90.7% (49/54) reported positive impact on service delivery and outcomes, ranging from service provision process, service utilization and health-related outcome indicators, however, higher proportion (90.7%, 49/54) of studies reporting positive effects could not exclude the presence of publication bias. Conclusion When collaboration patterns between PCPs and medical specialists other than general practice are implemented in integrated health services, it is necessary to ensure that approaches and contents of collaboration are specified, as well as the focus on the support of information systems and coordinators. Intervention studies related to health system and policy should emphasize describing the details of intervention design and implementation processes. Methodological quality assessment and meta-analysis are necessary to conduct in future studies on this topic.

Background Focusing on primary care is the primary content of health care policies, however, there is a lack of effective measurement tools in practice. Objective To construct a index system for county health system development focusing on primary care, provide a reference for its monitoring approaches, and perform analysis and presentation with application cases. Methods In the study conducted from 2021 to 2022, the index system, weights and percentage conversion methods were constructed based on literature review and Delphi method, case application and analysis were conducted based on the data of questionnaire survey, institutional survey and medical insurance collected by baseline survey among residents, patients and medical workers, as well as data of key informant interview, in 2 experimental counties of county health system reform in Guangxi Zhuang Autonomous Region from 2020 to 2022. Results The results of Delphi method showed that the authority coefficient of experts was 0.91, the coefficients of variation of two rounds of consultation were 0.14 and 0.13, respectively. The final constructed index system contains 3 domains, 15 dimensions, and 36 indicators, with a comprehensive index calculation method. The results showed that the overall scores for the two counties in Guangxi Zhuang Autonomous Region were 58.62 and 52.57, respectively, both of which were below the current national benchmark (60.00 points) . Conclusion Based on the data availability, the index system constructed in this study can be applied to monitor and evaluate county health system to achieve the goal of focusing on primary care, its application may improve visibility and priority of primary care development, facilitate the publish and implementation policies strengthening primary care.