Assessing the Impact of Integrated Specialist–Generalist Outpatient Models on Primary Care Experience among Chronic Disease Patients: Evidence from Shanghai

Objective In recent years, many primary healthcare institutions in China have implemented integrated general–specialist care models within community settings. This study aimed to examine patients’ objective experiences and evaluations of two types of community-based healthcare services—integrated general–specialist clinics for specific chronic diseases and general outpatient clinics. By comparing these evaluations, the study sought to identify the strengths and weaknesses of current service quality and to provide empirical evidence for improving community healthcare capacity and patient experiences. Methods From June to October 2024, a multistage sampling method was used to recruit patients with chronic diseases who received care either from integrated general–specialist clinics or general outpatient clinics in community health service centres implementing the integrated care model. Data were collected using the Primary Care Assessment Tool–Adult Short version (PCAT-AS) to assess patients’ evaluations of primary care services. Analysis of variance (ANOVA) was used to compare clinical characteristics between groups, and multiple linear regression analysis was conducted to identify factors influencing patients’ evaluations of primary healthcare services. Results A total of 581 valid questionnaires were collected. Patients attending integrated general–specialist clinics reported significantly higher scores across all dimensions and in the total PCAT-AS score compared with those attending general outpatient clinics. Multiple regression analysis indicated that attending an integrated general–specialist clinic (β = 0.195, P  < 0.001), being aged ≥ 71 years (β = 0.179, P  < 0.001), awareness of the harms of chronic diseases (β = 0.166, P  < 0.001), and receiving health education on related diseases from attending or family physicians (β = 0.181, P  < 0.001) were significantly associated with higher total PCAT-AS scores. Conclusions Integrated general–specialist care within community health service centres play an increasingly important role in safeguarding patient health and promoting the rational allocation of healthcare resources. Community centres offering such integrated services provide patients with chronic diseases a better primary care experience. However, further improvements are needed in care coordination (referral processes) and community orientation.