What is already known about this topic?:International frameworks for evaluating school public health primarily emphasize enhancing student health literacy, whereas domestic research tends to focus on isolated domains, resulting in a fragmented system lacking comprehensive integration. What is added by this report?:Through two rounds of expert consultations, this study developed a three-tier evaluation indicator system for Beijing's primary and secondary school public health system, comprising 59 indicators. The results demonstrated strong expert consensus and high reliability. What are the implications for public health practice?:The indicator system developed in this study demonstrates high levels of expert participation, authority, and coordination, which supports its practical applicability. It provides actionable guidance for strengthening and improving public health systems in primary and secondary schools.

In China, the absence of a strict referral system leads to overcrowding in tertiary hospitals and underutilization of primary care, challenging the implementation of a tiered diagnosis and treatment system. This study investigates how differential health insurance reimbursement rates can be leveraged to guide patient flow. We developed an agent-based simulation model, calibrated with real-world data on hypertensive inpatients from Beijing (2015-2017). The model simulated patient healthcare-seeking choices under various reimbursement scenarios for primary, secondary, and tertiary hospitals. Adjusting reimbursement rates significantly redirected patient flow and altered medical insurance fund expenditure. Increasing the reimbursement rate for primary hospitals proved particularly effective in channeling patients toward them. We identified an optimal balance-maximizing the proportion of hypertensive inpatients seeking care at primary hospitals (achieving 36.41%, compared to an observed baseline of 16.39%) while controlling total fund expenditure-when reimbursement rates were set at 95% for primary, 85% for secondary, and 70% for tertiary hospitals. Differential health insurance reimbursement serves as a potent policy lever to steer patient flow within a tiered healthcare system. The agent-based modeling approach provides a valuable tool for policymakers to simulate and identify optimal reimbursement strategies, thereby promoting efficient healthcare delivery and sustainable fund management.

INTRODUCTION:Despite the basic medical insurance system achieving 95% coverage in China, platform workers in new forms of employment (PWNFEs) face significant challenges in maintaining continuous participation in basic medical insurance (CPBMI). This study aims to identify distinct patterns of CPBMI by occupational characteristics (CPBMI-OC) and their associated factors. METHODS:We conducted a cross-sectional survey with 641 PWNFEs in China using a structured questionnaire and employed latent class analysis (LCA) to identify patterns of CPBMI-OC. We utilized multinomial logistic regression to examine the associations between patterns of CPBMI-OC and variables, including demographics, socioeconomic status, medical service utilization, and health and insurance statuses. RESULTS:Among the 641 PWNFEs surveyed (74.4% aged 20-39 years, 79.4% male), the basic medical insurance (BMI) coverage rate was 38.7%, with 85.6% of participants reporting interruptions. LCA identified three distinct patterns: (1) fully interrupted, high-income, family migration class (13.4%); (2) high interruption, mid-income, stable residence class (30.9%); and (3) high continuity, low-income, non-contracted individual mobility class (50.7%). Urban and Rural Resident Basic Medical Insurance and urban hukou were positively associated with higher CPBMI probability. In contrast, higher education, better self-rated health, female gender, supplementary insurance coverage, and platform-insurance enrollment linkage were associated with a higher interrupt probability of CPBMI. CONCLUSION:This study highlights the low CPBMI rate. The diverse patterns of CPBMI-OC among PWNFEs underscore the systemic challenges associated with flexible BMI enrollment options, which hinder continuous insurance participation. Our findings emphasize the need for targeted policy interventions to address structural inequities, improve the inclusiveness of BMI schemes, and better accommodate the diverse needs of PWNFEs.

The prevalence of chronic diseases is influenced by multiple factors, making their management a complex social and multi-sectoral issue. China has implemented a multisectoral synergistic model for managing chronic diseases; however, enhancing its synergistic effectiveness remains necessary. This study aims to investigate the factors influencing multi-sectoral synergy in chronic disease management. We employed purposive sampling and multi-stage stratified sampling method to survey 160 personnel involved in chronic disease management across 10 departments of county-township-village three level in H District, Beijing. The SFIC (Starting Conditions, Facilitative Leadership, Institutional Design, and Collaborative Process) model served as the framework for the study, and structural equation modeling was conducted using AMOS 24.0 software to analyze the factors influencing the effectiveness of multisectoral collaboration in chronic disease management. The total effects of starting conditions, facilitative leadership, institutional design, and collaborative processes on the effectiveness of multi-sectoral collaboration in chronic disease management were 0.370, 0.638, 0.657, and 0.380, respectively. Among these factors, institutional design had the greatest impact on synergistic effectiveness (0.657). Additionally, the collaborative processes exhibited a mediating effect, contributing 0.525 to the total mediated effect. Starting conditions, facilitative leadership, institutional design, and collaborative processes all influence the effectiveness of multi-sectoral collaboration in chronic disease management, with the collaborative processes mediating these effects. Further efforts should focus on refining institutional design and facilitative leadership, while also considering the influence of the collaborative processes on synergistic effects.

OBJECTIVE:To describe how patients choose between primary care institutions (PCIs) and non-PCIs using rational choice theory from the perspective of survival rationality, economic rationality, and social rationality. METHODS:Multi-stage stratified sampling and convenience sampling were applied to select 1723 patients to conduct the questionnaire survey. Chi-square test and binary logistic regression were performed to analyze the factors associated with patients' choice of PCIs. RESULTS:In total 55.83% of 1723 patients would attend a PCIs for healthcare. The results of the univariate analysis revealed that patients who are female (58.46%, P = .015), suffering from chronic diseases (56.26%, P = .047), inpatients (67.58%, P < .001), Beijing (59.62%, P = .002), partial understanding of the family doctor contracting system (62.30%, P < .001), and not understanding of the medical alliance policy (58.04%, P = .031) had significantly higher probability of choosing PCIs. Logistic regression analysis showed that females were more unwilling to attend PCIs (odds ratio (OR) = 0.822, 95%CI: 0.676-0.999). Following survival rationality, patients without chronic diseases were more likely to attend PCIs (OR = 1.834, 95%CI: 1.029-3.268), and inpatients were more unlikely to attend PCIs (OR = 0.581, 95%CI: 0.437-0.774). From an economic rationality perspective, patients from the Fujian province were more likely to attend PCIs (OR = 1.424, 95%CI: 1.081-1.876). From a social rationality perspective, patients who partial understanding of the family doctor contracting system were more unlikely to attend PCIs (OR = 0.701, 95%CI: 0.551-0.892), and patients who partial and complete understanding of the medical alliance policy were more likely to attend PCIs (OR = 1.340, 95%CI: 1.064-1.687; OR = 1.485, 95%CI: 1.086-2.030). CONCLUSIONS:Survival, economic, and social rationality are involved in patients' choice to attend PCIs. Compared to survival rationality and social rationality, economic rationality showed a lower association with patients' choice to attend PCIs. Medical institutions are recommended to adopt a "patient health-centered" approach when providing medical services and further optimize the family doctor contracting system and construction of medical alliances.

Background : Outpatient medical care payment play a pivotal role in the reform of medical insurance payment methods. With ongoing reforms in China, a variety of payment strategies, including capitation and the ambulatory patient groups (APG) point method, are being progressively implemented. Objective : This study aims to identify appropriate capitation calculation methods for chronic diseases in Beijing and to provide recommendations for implementing capitation payments reforms in the city. Methods : We focused on four prevalent chronic diseases—hypertension, diabetes, coronary heart disease, and stroke—and analyzed basic medical data and public health funding in Beijing's districts C and H as case studies. This research was aimed at developing a capitation calculation method tailored to these locales, determining payment standards for major chronic diseases in primary care clinics, and thus supporting the advancement of capitation reform for outpatient chronic diseases. Results : Using medical insurance data and public health funding data from 2017 to 2019, a top-down allocation was employed to determine the capitation payment standards in district H: 4,693.11 Yuan for hypertension, 6,597.70 Yuan for diabetes, 5,644.46 Yuan for coronary heart disease, and 6,437.78 Yuan for stroke. A bottom-up costing approach was used in district C, resulting in payment standards of 4,884.18 Yuan for hypertension, 5,960.63 Yuan for diabetes, 3,733.93 Yuan for coronary heart disease, and 3,886.66 Yuan for stroke. Conclusion : The outpatient costs associated with different chronic disease populations vary considerably. In view of maintaining equity in medical insurance and the fairness of capitation fees, it is imperative to apply risk adjustments to the benchmark capitation fee. Personalized services should be tailored to the diverse types and severities of chronic diseases. It is also crucial to provide customized basic medical and public health services to various chronic disease patients as part of the capitation payment reform for outpatient services. Additionally, enhancing the capabilities of community health services in managing chronic diseases, improving contracting percentages, and establishing effective incentive and evaluation mechanisms for general practitioners are essential for equitable distribution of surplus from capitation payments.

BACKGROUND:Death burden of stroke is severe with over one-third rural residents in China, but there is still a lack of specific national and high-quality reports on the urban-rural differences in stroke burden, especially for subtypes. We aimed to update the understanding of urban-rural differences in stroke deaths. METHODS:This is a descriptive observational study. Data from the national mortality surveillance system, which covers 323.8 million with 605 disease surveillance points (DSPs) across all 31 provinces, municipalities, and autonomous regions in China. All deaths from stroke as the underlying cause from 2015 to 2020 according to DSPs. Crude mortality rate and age-standardized mortality rate (ASMR) were estimated through DSPs. Average annual percentage change was used to explain the change in mortality rate. RESULTS:From 2015 to 2020, the majority of deaths from all stroke subtypes occurred in rural areas. There were significant differences between the changes of urban and rural ASMRs. On the whole, the changes in urban areas were evidently better, and the ASMR differences were basically expanding. Stroke ASMR in urban China decreased by 15.5%. The rural ASMR of ischemic stroke increased by 12.9%. The rural and urban ASMRs of intracerebral hemorrhage decreased by 24.9% and 27.4%, and those of subarachnoid hemorrhage decreased by 29.5% and 40.4%, respectively. The highest ASMRs of all stroke subtypes and the increasing trend of ischemic stroke ASMR make rural males the focus of stroke management. CONCLUSIONS:The death burden of stroke varies greatly between urban and rural China. Rural residents face unique challenges.

Background Family doctor contract services (FDCS) have been introduced in China in 2009 [ 1 ] and rapidly expanded recently. This study sought to investigate factors that influenced the willingness of Chinese residents to use FDCS. Methods We employed multistage stratified and convenience sampling to administer questionnaires to 1455 Beijing, Qinghai, and Fujian residents. The willingness of residents in each province to contract family doctors was analyzed using the chi-square test and binary logistic regression. Results The analysis in this study found that the signing rate of family doctors in China was about 27.77%, with differences in the signing up levels in Beijing (13.68%), Fujian (64.49%) and Qinghai (11.22%). In addition, the binary logistic regression results emphasized the relative importance of age, education, medical preference and policy knowledge on the willingness to sign up. Distrust of family doctors’ medical skills (65.7%), not knowing how to contract (47.8%), and not knowing what medical problems can be solved (41.1%) were the top three reasons accounting for the reluctance of residents to contract with family doctors. Conclusion Residents from different backgrounds have different willingness to sign up, so the specific circumstances and needs of different groups should be taken into account. In order to increase the signing-up rate, consideration can be given to promoting the family doctor model in Fujian throughout the country. Individual hesitation can be eliminated by increasing the reimbursement rate of health insurance, reducing the out-of-pocket expenses of contracted patients, and providing incentives of certain discounts for consecutive contracted patients.

BACKGROUND:We explored the impact of medical service fee adjustments on the choice of medical treatment for hypertensive patients in Beijing. We hope to provide decision-making reference to promote the realization of hierarchical diagnosis and treatment in Beijing.METHODS:According to the framework of modeling simulation research and based on the data of residents and medical institutions in Beijing, we designed three models of residents model, disease model and hospital model respectively. We then constructed a state map of patients' selection of medical treatment and adjusted the medical service fee to observe outpatient selection behaviors of hypertensive patients at different levels of hospitals and to find the optimal decision-making plan.RESULTS:The simulation results show that the adjustment of medical service fees can affect the proportion of patients seeking medical treatment in primary and tertiary hospitals to a certain extent, but has little effect on the proportion of patients receiving medical treatment in secondary hospitals.CONCLUSIONS:Beijing can make adjustments of the current medical service fees by reducing fees in primary hospitals and slightly increasing fees in tertiary hospitals, and in this way could increase the number of patients with hypertension in the primary hospitals.

Objective:To explore the construction of medical insurance high-quality development index evaluation system in Beijing,and to provide a reference and basis for the objective evaluation and continuous improvement of the development effect of medical insurance in Beijing.Methods:The index system was determined through two rounds of Delphi consultation,based on preliminary literature research and expert discussions,taking into account the national and Beijing’s "14th Five-Year Plan" medical security development goals.Results:A system of indicators for assessing the quality development of medical security in Beijing,consisting of five primary indicators,14 secondary indicators and 21 tertiary indicators of equity,safety,wisdom,synergy and value and their weights,was formed.The positive coefficient of experts in both rounds of consultation was 100%,and the authority coefficient of experts was 0.70 and 0.79.Conclusion:The evaluation index system for high-quality development of medical insurance in Beijing is reasonable,scientific and reliable,which can serve as a model for the development and implementation of policies aimed at promoting high-quality medical insurance development.

如何有效地约束医疗机构费用增长,合理利用医疗卫生资源,是全世界面临的挑战之一.在全球医疗卫生体制改革中,支付作为"控制柄"之一被寄予厚望.文章以门诊按人头付费支付方式改革为视角,通过对部分国家门诊按人头付费的实践与改革趋势进行分类和梳理,并基于我国国情提出建议,以期为我国门诊医保支付方式改革提供借鉴.

Abstract Background Promoting hierarchical diagnosis and treatment is important to deepen medical reform in China. One effective way to achieve this goal is by implementing medical insurance payment policies. Currently, China uses differentiated reimbursement rates for medical insurance to steer patients toward hospitals of different levels. Objective To study the medical services-seeking behaviors of hypertensive inpatients in response to the change in the basic medical insurance policy of urban residents and the impact on medical insurance expenses, and to promote hierarchical diagnosis and treatment and improve the allocation efficiency of health resources. Methods This study utilized agent modeling simulation to establish a simulation system consisting of four models of patients, diseases, hospitals, and policies. Based on data from urban residents and different levels of hospitals in Beijing from 2015 to 2017, the medical service-seeking behavior of hypertensive inpatients at different levels of hospitals was observed by adjusting the reimbursement rate of medical insurance to find the optimal decision point to balance patients' medical-seeking behavior and medical insurance fund control. Results Modifying hospital reimbursement rates at different levels can impact patient flow and medical insurance fund utilization. Increasing the reimbursement rate for primary hospitals encouraged more patients to seek care at these facilities. When the reimbursement rates of the primary, secondary, and tertiary hospitals were 95%, 85%, and 70%, respectively, the highest proportion of hypertensive inpatients seeking care at primary hospitals was observed while ensuring the best balance between the proportion of primary hospital visits and total expenditure of the medical insurance fund. Conclusion Our system model complements the traditional qualitative and quantitative research methods and provides a better simulation and prediction of the impact of medical insurance policy adjustment on patients' medical treatment choice behavior and medical insurance fund expenditure. A linkage mechanism of medical and pharmaceutical policies is proposed to promote the synergy of health insurance policies. Enhancing the capacity of primary hospitals is crucial for promoting hierarchical diagnosis and treatment, and the adjustment of medical insurance payment policy can only serve as a means to achieve this goal.

Abstract Objective As a potentially life‐threatening condition, myasthenia gravis (MG) has limited epidemiological studies on mortality. We aim to provide demographic distribution, geographical variation, and temporal trend of MG‐related mortality in China. Methods The national population‐based analysis was conducted based on records derived from the National Mortality Surveillance System of China. All deaths related to MG were identified from 2013 to 2020, and MG‐related mortality was evaluated by sex, age, location, and year. Results A total of 4224 deaths were related to MG during 2013–2020, and the median age at death of MG was 59.45 years, significantly lower than that in the general population (75.47 years, P < 0.05). In 2020, the age‐standardized mortality rate of MG was 1.86 per million people and markedly higher in males than in females (2.37 vs. 1.31 per million). The mortality rate per million was lower than 1 in young children, peaking at 2.83 only in males (vs. 0.36 in females) aged 10–19 years, and substantially increased with age, reaching the highest rate of 13.31 for males and 10.58 for females aged 80 years and older. Geographical disparity across China was observed with the highest age‐standardized mortality rate in Southwest (2.53 per million). From 2013 to 2020, MG‐related mortality rate showed an increasing trend with the average annual percentage change of 3.5% (95% CI, 1.4–5.6). The notable increases occurred in age 10–19 years and over 70 years. Interpretation In China, MG‐related mortality was notably high among adolescent males and the elderly. The increasing death burden due to MG highlight challenges to disease management.

Background The reimbursement of outpatient services is an essential part of the reform of medical insurance payment methods. With the comprehensive promotion of the reform on the medical insurance payment methods for inpatient services in China, the reform on insurance payment methods for outpatient services, such as capitation-based reimbursement and ambulatory patient groups (APG) point method, will gradually be put on the agenda. Objective To explore a capitation-based reimbursement scheme for chronic diseases applicable to Beijing based on an analysis of capitation-based reimbursement implemented in different countries and regions and the current situation of chronic disease management in Beijing, to provide a reference for implementing the capitation-based reimbursement reform for chronic diseases in Beijing. Methods This study used information related to essential medical services, reimbursement by health insurance, and essential public health service funds in Beijing's C and H districts. Then through an analysis of the information, the calculation method for capitation-based reimbursement standard for four common chronic diseases (hypertension, diabetes, coronary heart disease and stroke were selected in this study) applicable in the districts was designed to calculate the capitation-based reimbursement standard for major chronic diseases in primary outpatient clinics, providing a reference for promoting the capitation reform for chronic diseases in outpatient clinics. Results By analyzing the above-mentioned information in 2017—2019, the capitation-based reimbursement standard was 4 693.11 yuan/person for hypertension, 6 597.70 yuan/person for diabetes, 5 644.46 yuan/person for coronary heart disease, and 6 437.78 yuan/person for stroke in H district calculated using the bottom-up costing, and was 4 884.18 yuan/person for hypertension, 5 960.63 yuan/person for diabetes, 3 733.93 yuan/person for coronary heart disease, and 3 886.66 yuan/person for stroke in C district calculated using the top-down estimating. Conclusion In calculating the capitation-based reimbursement standard, as different chronic disease patient groups have different outpatient costs, considering the equity of medical insurance reimbursement and the rationality of capitation-based reimbursement, it is necessary to adjust the risk of the benchmark capitation, and develop personalized service packages for different types and severity of chronic diseases. In the promotion of capitation payment for chronic disease patients, it is necessary to provide personalized essential medical service and public health service packages for patients with different chronic diseases, further improve the chronic disease management capacity of community health institutions to improve the contracting rate and establish an effective incentive and assessment mechanism for general practitioners to rationally allocate capitation balance.

目的:基于医保新发展理念,以国家宏观政策为导向,结合北京市医疗保障改革工作重点,构建医保高质量发展评价指标体系,评价2018-2021 年北京市医疗保障高质量发展状况.方法:运用描述性分析结合灰色综合评价方法,从参保公平、管理服务、基金监管、社会协同、运行效果五个维度进行分析.结果:整体上,北京市2018-2021 年医保高质量发展水平呈现稳步提升趋势,各维度指标取值逐步向最优值靠近.结论:评价指标体系和评价方法具有科学性与适用性.北京市医保发展水平不断提高,但发展不稳定和不平衡问题显现;医保制度体现一定公平性,应保尽保与重复参保问题仍存在;医保基金平稳可持续运行,制度间存在筹资待遇差距;医保基金监管机制逐步健全,监管方式亟需创新优化.

为完善我国慢性病门诊医疗保障制度,提高慢性病患者医疗保障待遇,基于正义理论并使用内容分析法梳理了8个医保支付方式改革试点地区典型城市现行慢性病门诊医疗保障政策.从保障范围、支付方式等方面进行描述并比较分析,总结现行慢性病政策的优缺点,并针对未来改进方向给出建议,以构建更合理的慢性病门诊医疗保障体系.

目的 了解大学生熬夜现状及其影响因素,利用教育诊断找出促使其戒断"习惯性熬夜"行为的要素,为减少大学生熬夜行为、培养大学生健康的行为生活方式提供参考.方法 采用配额抽样的方法在某医学院校大二至大四相关专业的大学生班级群中发放电子问卷二维码,对医学院校大学生熬夜行为现状、熬夜危害的认知、熬夜态度进行调查,以教育诊断为核心分析"习惯性熬夜"行为的倾向因素、促成因素、强化因素,并采用Logistic回归模型探索3类因素对大学生习惯性熬夜行为的影响.结果 共发放570份问卷,收回有效问卷561份,有效应答率为98.4％.91.63％的大学生存在熬夜行为;每周熬夜天数≥4 d的占比高达77.72％,不同专业的熬夜频率差异有统计学意义(P＜0.05);仅有26.87％的大学生对于熬夜定义认知正确;多因素分析中,熬夜行为随熬夜频率OR=6.939,95％CI:3.986～12.079)、补觉行为(OR=3.094,95％CI:1.129～8.481)、选择工作日熬夜行为的增加而增多,而对熬夜认知定义越清晰则越不倾向于熬夜(OR=2.501,95％CI:1.506～4.152).结论 该医学院校学生有强烈改变熬夜行为的意愿却依旧熬夜,主要是由于对熬夜定义认知不清习惯性熬夜行为的形成,与个体心理资本密切相关,减轻其社会压力,并增强学校对学生的心理关注是根本解决办法.

Background The Chinese hierarchical treatment system expects patients to first visit primary medical institutions (PMIs), and patients' willingness determined their utilization of primary health care. The aim of this study was to explore the factors associated with patients' willingness to make their first visit to PMIs. Methods We employed multistage stratified sampling and convenience sampling to administer questionnaires to 1,507 patients in Beijing, Qinghai, and Fujian. Patients' willingness of first visit in PMIs was analyzed using Chi-square test and binary logistic regression. Results Of the 1,507 participants in the survey, 55.1% were willing to make their first visit in PMIs. Fewer patients in Beijing (17.6%) are willing to make their first visit in PMIs than those in Qinghai (71.9%) and Fujian provinces (72.0%). Binary logistic regression analysis revealed that higher recognition of the community first visit policy and higher satisfaction with the medical technology of PMIs are associated with patients' willingness of first visit in PMIs. Conclusions Due to differences in local economic conditions, medical resources, and policy formulation, there are differences among provinces in patients' willingness of first visit in PMIs. To increase patients' rate of visits in PMIs, it is important to improve service capacity and quality of PMIs and change residents' attitudes for PMIs.

目的 了解北京市某农村地区中老年慢性病患者焦虑和抑郁倾向发生情况,并探讨影响慢性病患者焦虑和抑郁的因素.方法 采用多阶段分层抽样的方法对北京市某农村地区645例慢性病患者进行问卷调查,问卷包括社会人口学特征、患病情况、心理健康抑郁症状量表(PHQ-9)、广泛性焦虑量表(GAD-7)等内容.焦虑和抑郁倾向与社会人口学特征之间的单变量分析采用χ2检验,多变量分析采用二元Logistic回归分析.结果 中老年慢性病患者有抑郁倾向的检出率为36.3％,有焦虑倾向的检出率为26.8％,20.6％的患者同时检出有抑郁和焦虑倾向.单因素分析结果显示,性别、文化程度、年收入、患慢性病类型是慢性病患者出现焦虑和抑郁倾向的影响因素.Logistic回归分析结果显示,女性(OR=2.35,P<0.001)、患多种慢性病(OR=1.58,P=0.009)是慢性病患者出现抑郁倾向的危险因素,初中(OR=0.48,P=0.007)和高中及以上学历(OR=0.29,P=0.001)是患者出现抑郁倾向的保护因素;女性(OR=2.09,P=0.002)、患多种慢性病(OR=1.46,P=0.045)是患者出现焦虑倾向的危险因素,而小学(OR=0.57,P=0.03)和初中(OR=0.51,P=0.02)学历是患者出现焦虑倾向的保护因素.结论 北京市某农村地区中老年慢性病患者心理健康状况不佳,应加强慢性病患者抑郁和焦虑症状的评估,重点关注慢性病弱势人群的心理健康状况.

ObjectivesRural areas in China are more vulnerable to COVID-19 pandemic than urban areas, due to their far fewer health care resources. Village doctors, as rural grassroots health workers in China, have been actively engaged in the pandemic prevention and control. This study aims to describe the roles of village doctors in rural China, and the challenges they have faced during the prevention and control of the COVID-19 pandemic. SettingThis study was conducted in three towns in Huairou District, Beijing, China. DesignWe carried out semi-structured interviews with 75 key informants. All the interviews were audio-recorded and transcribed verbatim. We employed thematic analysis to define themes and sub-themes from the qualitative data. ResultsWe reported four themes. First, the village doctor guided the village committee to carry out decontamination, monitored home-isolated residents, and disseminated knowledge on prevention of the COVID-19 pandemic during the rural pandemic prevention and control. Second, they took pandemic prevention measures in village clinics, distributed pandemic prevention materials, and undertook pre-screening triage. Third, village doctors provided basic medical care, including treatment of common diseases as well as the purchase and delivery of medicines to villagers. Fourth, village doctors faced difficulties and challenges, such as inadequate medical skills, aging staff structure, and lack of pandemic prevention materials. ConclusionsDespite many difficulties and challenges, village doctors have actively participated in rural pandemic prevention and control, and made outstanding contributions to curbing spread of COVID-19 pandemic in rural areas. Village doctors provide basic health care while participating in various non-medical tasks.