Rural physician program and health outcomes: Evidence and mechanisms

Abstract Primary health care is the doorkeeper for individual health and the cornerstone of universal health coverage. Despite global efforts to promote universal health coverage, the underuse of primary health‐care services remains prevalent in rural areas, resulting in significant health concerns for rural residents. As a part of the policy to strengthen primary health care, the Chinese government has established a rural physician program to deliver immediate and convenient health‐care services. This paper provides the first evaluation of the effects of the rural physician program. We find that although most rural physicians have limited education and lack professional training, the program significantly improves rural residents' health outcomes. The improvement is mainly attributed to changes in health awareness and health‐seeking behaviours among rural residents, enhanced accessibility to nearby health‐care providers, regular health examinations and the diagnosis of simple diseases. However, the program demonstrates limited effect in addressing complex chronic diseases. Moreover, a cost‐benefit analysis indicates that the benefits derived from the program outweigh the associated costs. Therefore, this paper highlights a relatively cost‐effective way to improve the health status of rural and impoverished populations, particularly in developing countries and regions.

Authors

Publication Details

Journal
Canadian Journal of Economics/Revue canadienne d économique
Published
2026-09-06
DOI
https://doi.org/10.1111/caje.70089
Primary Topic
Healthcare Systems and Reforms
Type
article
Field-Weighted Citation Impact
0.00

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article

Rural physician program and health outcomes: Evidence and mechanisms

Qing Zhang, Jin Feng
Canadian Journal of Economics/Revue canadienne d économique
Healthcare Systems and Reforms
article

Rural physician program and health outcomes: Evidence and mechanisms

Qing Zhang, Jin Feng
article en

Abstract

Abstract Primary health care is the doorkeeper for individual health and the cornerstone of universal health coverage. Despite global efforts to promote universal health coverage, the underuse of primary health‐care services remains prevalent in rural areas, resulting in significant health concerns for rural residents. As a part of the policy to strengthen primary health care, the Chinese government has established a rural physician program to deliver immediate and convenient health‐care services. This paper provides the first evaluation of the effects of the rural physician program. We find that although most rural physicians have limited education and lack professional training, the program significantly improves rural residents' health outcomes. The improvement is mainly attributed to changes in health awareness and health‐seeking behaviours among rural residents, enhanced accessibility to nearby health‐care providers, regular health examinations and the diagnosis of simple diseases. However, the program demonstrates limited effect in addressing complex chronic diseases. Moreover, a cost‐benefit analysis indicates that the benefits derived from the program outweigh the associated costs. Therefore, this paper highlights a relatively cost‐effective way to improve the health status of rural and impoverished populations, particularly in developing countries and regions.

Canadian Journal of Economics/Revue canadienne d économique
National Natural Science Foundation of China
Partnerships for the goals
Openalex Percentile: Top 7%
Healthcare Systems and Reforms
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