Mingyue Wen

Countries worldwide are making efforts to achieve health equity. China focuses on the implementation of the policy goal of “improving the primary level” to eliminate the health equity gap. The main purpose of this study is to examine the effects of the healthcare reforms at the primary level in China and to analyze the key factors that can help to improve their effectiveness. From the perspectives of the policy attention mechanism and public policy analysis, this study will explore primary care reforms from policy formulation to policy implementation on the basis of grounded theory and empirical research on primary care reforms in Shenzhen, China, that was conducted from 2018 to 2019. The present study found that the government pays close attention to the medical level and service level of primary care services at the policy formulation phase but less attention to talent level and information sharing. At the same time, this study combined with empirical data from primary care centers in Shenzhen for the period covering 2018 to 2019 evaluates policy implementation and its effect. Multiple regression analysis revealed that the medical level, talent level, service level, and information sharing helped to develop primary care services and improved health equity. Nevertheless, this study reflects a deviation between policy formulation and policy implementation for the development of primary care policies. Empirical experience shows that the development of talent level and information sharing can significantly promote primary care services and health management. Therefore, this study implies that in the process of promoting the health equity at the primary level, more attention should be paid to the consistency between policy formulation and policy implementation. Additionally, the policy promotion and influence mechanism can be improved, particularly in terms of talent development and information sharing, in order to effectively promote the development of health equity at the primary level.

We conducted field research in China in 2010-2016 to diagnose the fundamental problems of Chinese public administration as a field of study (hereafter CPA). Our research question was ‘What are the obstacles that impede the genuine progress of CPA?’; our study shows that CPA lacks philosophical and intellectual underpinnings to justify its existence. Moreover, salvation is difficult as CPA has been suffering from three maladies, namely, reductionism, traditionalism, and conservatism, which together reinforce mediocrity. Furthermore, in order to become an indispensable field of study, scholars must strive to transform themselves so as to transform CPA. The implications for transformation of such practical examples as historical analysis and ‘optimal governance’ are discussed.