Evidence map›Paper›PMID 40877757›Full record

ArticleBMC primary care2025

Navigating fragmented care: a qualitative study on multimorbidity management challenges in Beijing's tiered healthcare system.

Conglei You, Jingyi Zhao, Tengyang Fan, Lingling Wang, Lijuan Zhang, Guohao Zhao, Huan Tang, Na Wang, Xu Yang, Mi Yao

Abstract read
In one paragraph

Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
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  3. Beyond breast cancer: mapping unmet needs and advancing an evidence-based framework of survivorship care.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Conglei You *Health Management Center, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 102208, China.
Jingyi Zhao *Department of General Practice, Miyun Hospital, Peking University First Hospital, Beijing, 101599, China.
Tengyang FanDepartment of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 56300, China.
Lingling WangDepartment of General Practice, Binzhou People's Hospital, Binzhou, Shandong, 256600, China.
Lijuan ZhangDepartment of General Practice, Huanggang Central Hospital, Huanggang, Hubei, 438000, China.
Guohao ZhaoDepartment of Neurology, The Third People's Hospital, Liaocheng, Shandong, 25200, China.
Huan TangDepartment of General Practice, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, China.
Na WangDepartment of General Practice, Affiliated Hospital of Jining Medical College, Jining, Shandong, 272029, China.
Xu YangDepartment of General Practice, Donghuashi Community Health Service Centre of Dongcheng District, Beijing, 100062, China.
Mi YaoDepartment of General Practice, Peking University First Hospital, Beijing, 100034, China. mi.yao@bjmu.edu.cn.

Funding

National High Level Hospital Clinical Research Funding /Scientific Research Seed Fund of Peking University First Hospital 2023SF31National Natural Science Founation of China 72304005
6 · The paper itself

Abstract

backgroundMultimorbidity is a growing public health concern, especially in countries with aging populations. Although a tiered healthcare system has been implemented to improve primary care, managing patients with multimorbidity has been challenging.

methodsThis study conducted focus group discussions involving 21 patients with multimorbidity in Beijing via a flexible topic guide to explore their experiences. Participants were sampled from urban and rural areas, ensuring a diverse representation of demographics and health conditions. The data were analyzed using the framework method. The themes and subthemes were identified through iterative coding and discussion.

resultsFour main themes emerged: (1) Living with multimorbidity, where patients view chronic conditions as an inevitable part of aging but struggle with self-management, particularly medication adherence and lifestyle modifications; (2) healthcare system challenges, driven by ineffective tiered policies and digital exclusion, especially among elderly patients; (3) financial burdens, with rural patients facing greater out-of-pocket costs due to insurance inequities and policy-induced strains; and (4) doctor-patient relationships, where communication gaps and a lack of continuity hinder patient-centered care. Patients emphasized the need for better care coordination, financial support, and empathetic communication.

conclusionThis study underscores systemic gaps in China's healthcare system for multimorbidity care. To address these issues, policymakers should prioritize (1) strengthening primary care coordination through multidisciplinary teams, (2) expanding financial protection for chronic disease management to reduce urban-rural disparities, and (3) training providers in patient-centered communication and shared decision-making. These actionable steps can serve as a blueprint for LMICs aiming to build integrated, patient-centered systems for multimorbidity management.

Indexed as

Delivery of Health CareMultimorbidityAdultAgedAged, 80 and overBeijingChronic DiseaseFemaleFocus GroupsHumansMaleMiddle AgedPatient-Centered CarePhysician-Patient RelationsPrimary Health CareQualitative ResearchChinaHealthcare experiencesMultimorbidityQualitative study

Identifiers

PMID40877757
PMCPMC12392530

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.