Since 2009, China implemented the primary health care (PHC) reform, with the overarching goal of providing accessible, efficient, equitable and high-quality healthcare services. This systematic review aims to examine the impacts of China’s PHC reforms on the health system and health outcomes.
Out of a total 42 selected studies, 11 studies specifically focus on health financing reform. These studies reveal that implementing deductible copayments for PHC services, providing essential public health services with free-of-charge, and introducing of family physicians have collectively increased PHC utilization in China. However, the impact of the PHC on healthcare costs remains unclear, while the evidence regarding financial protection is notably lacking. This study underscores the imperative of evidence-based comprehensive reforms and strong PHC systems in reshaping the dominance of hospital-based services and advancing towards UHC.