Background: In September 2015, the State Council of China issued guidelines on building a hierarchical medical system, stating that the first visit rate to primary healthcare (PHC) facilities should be increased to 70% for all medical facilities by 2017. This meta-analysis aims to estimate the willingness of the first visit to PHC services in China after the year 2015 and identify its determinants.
Methods: A meta-analysis was conducted.
Results: The combined estimate from 23 studies in China for the willingness rate of the first visit to PHC services was 56% (95% CI: 47-65). Chronic diseases may be one source of heterogeneity. We identified five main associated factors with the pooled odds ratio ranging from 1.39 to 10.28, including fair self-reported health status; high understanding of service content; good service attitude; solid expertise and advanced diagnostic methods; and a good medical environment.
Conclusion: In comparison with China's State Council recommendations, the willingness rate for the first visit to PHC services was significantly lower. The Government should develop strategies to facilitate the implementation of a hierarchical system for diagnosis and treatment.