The Operational Status and Evaluation of Fever Clinics in Primary Healthcare Centers in Shanghai: a Mixed Methods Study
摘要
Background In China, the national public health emergency response system was originally established in 2003 to address emerging respiratory infectious diseases. In response to the COVID-19 pandemic, fever clinics were instituted within Primary Healthcare Centers (PHC) to serve as a supplementary measure to the existing healthcare infrastructure during public health emergencies. The final goal is leading to the subsequent development of a more sophisticated public health emergencies medical care system. Objective Over the past three years, the utilization rates and visitation numbers of fever clinics have fluctuated irregularly. This study seeks to summarize the operational processes of PHC fever clinics during this period, identify existing challenges, and propose potential strategies for improvement. Methods A convenience sampling method was employed to select 16 PHC fever clinics, with one clinic chosen from each of the 16 districts in Shanghai. Managers of these fever clinics were invited to participate in semi-structured, in-depth interviews conducted from November 23, 2023, to June 18, 2024. The interview guide was developed by integrating insights from existing literature, government regulations, and a preliminary survey. The interviews centered on themes related to the establishment, operation, and challenges encountered by the clinics in recent years. The framework analysis method was employed to manage the qualitative data. Quantitative data were collected on the number of patients visiting fever clinics over the past three years, alongside population statistics and jurisdictional areas of each PHC. The correlation among clinic visits, population size, and population density was examined. Additionally, the SWOT framework was applied to assess the strengths, weaknesses, opportunities, and threats associated with PHC fever clinics. Results Of the 16 participants interviewed, 14 individuals (87.5%) possessed either vice-high or superior professional titles, w