Since in Weifang both public and private CHS provided preventive and outreach services when paid to do so, our case study is consistent with the idea that both public and private CHS could be willing to provide preventive services if the expected marginal revenue matches or exceeds that to be expected from clinical services, and the provider has clear guidelines and support.
This merits further study to understand such factors as preventive care, outreach efforts, medical interventions, in particular genomic (personalized) medical treatments, and resource allocation throughout the nation.
Preventive primary care outreach involves an initial comprehensive assessment and individualised follow-up.
13 14 Although several primary studies have looked at preventive primary care outreach interventions with older people, the findings have been mixed.
12 Two of the investigators for this study (JP, BH) did a meta-analysis of preventive primary care outreach interventions with older people.
In this study we found no effect of a preventive primary care outreach intervention for older adults at risk of functional decline on QALYs, costs of health and social services, functional status, self rated health, or mortality.
On the basis of an average loss to follow-up of 7.2% in the preventive primary care outreach trials in the meta-analysis, we conservatively assumed a 10% loss to follow-up for our sample size calculations.
12 We define preventive primary care outreach as proactive, provider initiated care above and beyond demand led routine care, provided in a community primary care setting, and linked to the usual care system.
Furthermore, a review on the effectiveness of preventive primary care outreach interventions aimed at older people was published, but this review also included trials not based on home visiting programs [ 7].
