In recent years, with the in-depth promotion of national basic public health service projects, primary health centers, as the carriers of the “last mile” for the implementation of services, have seen their service quality and coverage efficiency become directly related to the improvement of residents’ sense of health gain. Dahua Town of Dahua Yao Autonomous County is a region with a concentrated population and prominent urban-rural integration characteristics within the county. The health needs of residents in the jurisdiction exhibit diversified characteristics: the proportion of the elderly population is increasing year by year, and the demand for management of chronic diseases such as hypertension and diabetes is prominent; residents in some remote villages and towns have low awareness of public health policies and health knowledge; the masses in resettlement areas have an urgent demand for convenient medical services (such as TCM rehabilitation and basic diagnosis and treatment); at the same time, the standardized management of special groups such as patients with severe mental disorders also needs to be strengthened.

Based on the above background, this study takes all residents in the town served by Dahua Town Health Center as the research objects, specifically covering four core groups: first, the elderly aged 65 and above (including empty-nest, disabled, and other special elderly groups), focusing on their health physical examination and chronic disease management; second, patients with chronic diseases such as hypertension and diabetes, tracking the effect of health intervention; third, ordinary residents (including the masses in resettlement areas and permanent residents in villages and towns), focusing on their awareness and participation in public health services; fourth, patients with severe mental disorders and their families, focusing on the analysis of disease management and social support effects. The research scope also covers the core work areas of the health center, such as elderly health management, health publicity and education, TCM rehabilitation service supply, and screening and management of patients with severe mental disorders. By sorting out the specific service practices, this study explores the implementation path and effectiveness of primary public health services.

In this study, multi-dimensional data were systematically collected through the public health service archives, activity records, and electronic information system of the health center, including the annual coverage number of elderly free physical examinations, the detection rate of abnormal indicators in physical examinations and follow-up intervention records; the number of participants in different groups in various health publicity activities, the number of publicity materials distributed, and feedback opinions; the number of service person-times, disease distribution, and patient satisfaction of the TCM Rehabilitation Department after its establishment; the annual screening and review number of patients with severe mental disorders, standardized management rate, and drug distribution records; as well as the annual ranking of public health assessment and the annual change data of immunization program coverage rate.

Statistical descriptions (such as mean value and proportion) were used in data analysis to present the service scale and coverage effect. The intervention effect was evaluated through before-and-after comparison (such as the improvement range of immunization program coverage rate and the change in the standardized management rate of chronic diseases). The service quality was comprehensively judged by combining the feedback opinions of the masses, so as to comprehensively quantify the implementation effect of primary public health services.

From May 27 to June 2, 2023, Dahua Town Health Center launched the first round of full-coverage free health physical examinations for elderly residents aged 65 and above within its jurisdiction (see Table 1 ). For elderly individuals with limited mobility, a dedicated medical team was organized to carry portable inspection equipment and provide door-to-door services in remote villages and hamlets such as Dingkan Tun of Shangqi Village in June. In the same year, the door-to-door services covered 22 communities (villages) and 56 hamlets, ensuring that no elderly resident was left out of the physical examination (see Figure 1 and Figure 2 for specific scenarios). Since then, this program has been institutionalized as a regular annual initiative. The number of elderly residents covered by the physical examination reached 7557 in 2023 and increased to 8138 in 2024. By the end of 2024, a total of 15,695 elderly residents (7557 + 8138) had completed the health physical examination, with over 98% of newly added elderly residents covered each year.

In addition to basic measurements such as height, weight, and blood pressure, the physical examination included 12 targeted items, including liver function test, renal function test, routine blood test, fasting blood glucose test, routine urine test, Electrocardiogram (ECG), and abdominal ultrasound (covering general physical examination, auxiliary examination, and health guidance). These examinations could accurately screen for age-related high-incidence diseases such as hypertension, diabetes, hyperlipidemia, and abnormal liver or renal function. Data showed that during the physical examinations from 2023 to 2024, the initial screening positive rates for chronic diseases were 28.6% and 31.2%, respectively. Medical staff promptly established health records for elderly residents with positive results: 766 health records were created in 2023 (including 435 residents with positive screening results), and 2895 health records were created in 2024 (including 524 residents with positive screening results). All these residents were included in the key health management scope, providing solid data support for subsequent health interventions and treatment guidance ( Dahua Perspective, 2025-06-11 ).

After the physical examination, based on the physical examination results, the medical staff carried out targeted health guidance for the elderly. For common elderly diseases such as hypertension and hyperglycemia, they explained the harm and management points of the diseases, guided rational drug use, and emphasized the importance of taking drugs as prescribed by doctors for disease control; they popularized scientific diets, suggested a low-salt, low-sugar, and low-fat diet, and increased the intake of vegetables, fruits, and high-quality protein; they also taught simple exercise methods such as slow walking and tai chi, and encouraged moderate exercise.

Through continuous health guidance, the elderly’s awareness of senile diseases has improved. Some elderly people have actively adjusted their living habits, such as reducing the intake of pickled food and regularly monitoring blood pressure and blood glucose. The control rate of indicators such as blood pressure and blood glucose has gradually improved, health awareness and self-management ability have been enhanced, and the quality of life has improved to a certain extent.

On June 11, 2025, Dahua Town Health Center and Fengxiang Village Neighborhood Committee jointly held a publicity and education activity, distributing 1193 copies of 16 types of publicity leaflets and 100 publicity gifts, benefiting 253 people. The activity popularized 12 types of basic public health service projects, interpreted policies and regulations, and guided residents to develop healthy living habits; at the same time, it publicized work safety, telecom fraud prevention, and other content to improve residents’ comprehensive cognition. Before that, a number of similar activities had been carried out, covering a large number of residents, effectively improving residents’ awareness and participation in public health services. Some residents said that they had a clearer understanding of national service policies and local medical resources, and made more reasonable medical treatment choices ( Dahua Media, 2024-12-26 ). See Figure 3 and Figure 4 below for details.

On March 3, 2024, the TCM Rehabilitation Department of the Nayin Branch of Dahua Town Health Center was inaugurated, filling the gap in regional rehabilitation medical care. The department has two floors of business rooms, equipped with advanced equipment such as an air wave pressure circulation therapy instrument and an electric standing bed; there are 21 medical staff members who provide professional rehabilitation services by combining traditional TCM characteristic treatments (acupuncture, massage, traditional Chinese medicine, etc.) with modern rehabilitation medicine. Since its establishment, the department has provided professional rehabilitation services for many patients, helping them relieve pain, promote rehabilitation, and improve the accessibility of primary rehabilitation services. Residents can enjoy high-quality TCM rehabilitation services at their doorsteps, with high satisfaction ( Dahua Media, 2024-03-04 ). See Figure 5 for details.

From February 29 to March 1, 2024, in cooperation with Hechi Fourth People’s Hospital, the screening, review, and diagnosis of patients with severe mental disorders were carried out. A total of 238 patients were given follow-up guidance on medication, and three months of drugs were distributed for free; 11 suspected cases were screened out, and hospitalization for standardized treatment was suggested. This activity improved patient information, enhanced the families’ understanding of the disease, increased the patients’ treatment compliance and the masses’ sense of happiness, and laid a solid foundation for subsequent patient management and public health services ( Dahua Perspective, 2024-03-02 ).

In terms of public health assessment, Dahua Town Health Center has always ranked first among the 16 towns in the county, and its staff have been rated as excellent employees every year. The immunization program coverage rate has increased from 76% in the past to more than 90%. By optimizing vaccination services and strengthening publicity and mobilization, the coverage rate of the children’s immunization program has been improved, and an effective population immune barrier has been established.

Through the diversified practice of primary public health services, Dahua Town Health Center has achieved remarkable results in many aspects: elderly health management covers a wide range, helping the elderly to detect and intervene in health problems early; health publicity improves residents’ health knowledge and policy awareness, and promotes the development of healthy living habits; the TCM Rehabilitation Department fills the gap in regional rehabilitation services and expands the connotation of primary medical services; the management of patients with mental disorders standardizes the diagnosis and treatment of patients and maintains the social mental health environment; the excellent results of public health assessment and the immunization program demonstrate the service quality and management level. These practices have effectively improved the health level and medical satisfaction of residents in the jurisdiction, and promoted the construction process of “Healthy Dahua”.

Although certain achievements have been made, there are still deficiencies. For example, the participation of some residents in public health services needs to be further improved, the service scope and depth of the TCM Rehabilitation Department can be further expanded, and the long-term management mechanism for patients with mental disorders needs to be continuously improved. In the future, it is necessary to strengthen the innovation of publicity and promote services in a way that is closer to the lives of residents; deepen the characteristics of TCM rehabilitation and explore more appropriate technologies; optimize the management process of patients with mental disorders, strengthen multi-department collaboration, and continuously improve the efficiency of primary public health services.

The practice of Dahua Town Health Center shows that primary health centers need to be based on the needs of residents, accurately carry out the integrated practice of public health services and medical services, strengthen multi-department collaboration (such as cooperating with community neighborhood committees for publicity), pay attention to the construction of talent teams (the allocation of medical staff in the TCM Rehabilitation Department) and equipment investment, take assessment as the guidance and health as the goal, and continuously optimize the service content and form. Only in this way can they play a greater role in primary health work and provide higher-quality and more comprehensive health protection for residents ( Li, 2022 ).