Primary care functional features in China and their relationship with health service outcomes: a 15-year mixed methods systematic review protocol

IntroductionGlobally, primary care (PC) features like accessibility, continuity, and coordination enhance health outcomes. In China, 940,000 public facilities delivered 4.266 billion PC visits in 2022 (50.68% of total visits), focusing on chronic disease management and public health. Unlike Western gatekeeper models, Chinas PC lacks this structure, influencing its characteristics and effectiveness. ObjectiveThis review synthesises Chinas PC functional features and their relationship with health service outcomes since 2009, combining quantitative and qualitative evidence. MethodsUsing the JBI mixed-methods framework, we will search PubMed, Embase, Web of Science, Google Scholar, CNKI, and Wanfang Data for studies (quantitative, qualitative, mixed-methods). Two reviewers will screen and assess quality with JBI tools (>50% threshold). A convergent segregated approach integrates quantitative data (feature strength, associations with outcomes) with qualitative insights (stakeholder views on features and effects). DiscussionThis review may shed light on the functional features of Chinas primary care system and their relationship with health service outcomes. The synthesized evidence could inform clinical practice, health service delivery, and health policy regarding the health service process of primary care in China, while also identifying areas for future research.