Service Availability and Readiness for Chronic Disease Management in Primary Care Facilities: A Three-Year Cohort Study in Henan, China (2021-2023)

Introduction Chronic diseases, such as cardiovascular diseases, chronic respiratory diseases, and diabetes, constitute a major global public health burden, with China facing escalating challenges due to demographic and lifestyle transitions. Effective management necessitates a well-functioning primary healthcare system capable of early diagnosis, standardized treatment, and continuous care. However, gaps remain in the availability and readiness of primary care facilities to deliver comprehensive chronic disease management services, particularly in Henan Province, a populous region in central China with unique healthcare delivery challenges. Methods This cohort study employed a combination of quantitative and qualitative methods, collecting data annually from 2021 to 2023 across 2,700 primary healthcare institutions in Henan Province. The study assessed the diagnostic and treatment capabilities for seven common chronic diseases: hypertension, coronary heart disease, cerebrovascular diseases, hyperlipidemia, chronic bronchitis, chronic pulmonary heart disease, and diabetes. Data were collected via structured questionnaires administered to institutional representatives of primary healthcare institutions, and analyzed using Excel 2021 (Microsoft Corporation) and GraphPad Prism 10.0. Results The study found that primary healthcare institutions in Henan Province demonstrated high diagnostic and treatment coverage rates for hypertension, hyperlipidemia, chronic bronchitis, and diabetes, with rates surpassed 98% for hypertension and diabetes in 2023. However, lower rates were observed for coronary heart disease, cerebrovascular disease, and chronic pulmonary heart disease, primarily due to insufficient equipment, lack of skills, and manpower shortages. Barriers to service delivery included difficulties in making correct diagnoses, applying diagnostic tools, and interpreting laboratory results, as well as challenges in adhering to standardized treatment pathways. Conclusion Henan Province's primary healthcare institutions have advanced in chronic disease management but struggle with complex conditions. Addressing these gaps requires targeted investments, enhanced training, and policy reforms to achieve "Healthy China 2030" goals.