Since they are considered an important part of the Chinese Urban Health Reform System, Community Health Centers (CHCs) have been established throughout the entire nation; they are currently undergoing substantial re-construction. Until 2002, 31 provinces including the autonomous regions and central government-ruled cities such as Beijing, Shanghai, ChongQing and Tianjin had a total of around 2406 CHCs and 9700 service stations. However, these CHCs are facing many problems in delivering their services, attributable to the different speeds of development among centers, lack of resources, and imbalance in the sizes of CHCs, so it is difficult for them to meet citizens' needs. Nevertheless, the CHCs are considered the main primary institutions for offering basic medical and public health services. They are regarded as the basic networks for medical treatment and public health surveillance. Therefore, redistributing health resources towards CHCs can ensure social health equality .
Traditional health methods such as Traditional Chinese Medicine (TCM) concentrate more on cure than prevention and/or care. By the beginning of the 21st century, traditional methods could no longer cope with the tasks of the new CHCs or patients' health service demands such as care, emergency treatment and rehabilitation. Hence, there is an urgent need to develop the CHC services in order to meet the residents' demands. The main question is how to develop these centers and expand them, and at the same time be able to attract patients to use them. Another important question is how to build a trusting, stable and harmonious doctor-patient relationship. These are all important variables in the advancement of the Chinese health reform system.
The Chinese CHCs are involved in delivering six main functions 
Disease prevention and control: in disaster situations, the main task of the CHCs is to implement epidemic prevention measures effectively, while in more normal times it is to promote prevention among the residents. By following the sector's instructions on epidemic prevention, the CHC has to report carefully on the coverage of expanded planned immunizations (EPI) and the delivery of routine immunizations to children within their communities, such as carrying out community vaccine immunizations, investigating epidemics and contagious diseases, and other preventive procedures.
Health care services: these include health care surveys of family members, children, women, the elderly and the disabled.
Health education: by promoting geriatric and women's health education, and extending such education to students in schools around the country. In supporting the latter idea, the notion of a health-promoting school is relatively new. "The health promoting school aims at achieving healthy lifestyles for the total school population by developing supportive environments conducive to the promotion of health. It offers opportunities for, and requires commitments to, the provision of a safe and health-enhancing social and physical environment" (World Health Organization, 1993). Also, health education is essential in providing residents, those located around the CHC, with general medical and disease prevention information and treatment consultations, so that residents' concepts of care and health investment are promoted
Family planning: the task here is to implement a nationwide family planning policy. This is performed by education and counseling about family planning.
Medical treatment service: the main work is to consult, diagnose and treat residents/dwellers for common, frequently-occurring and chronic diseases.
Community rehabilitation: this involves setting up family sick-beds, providing rehabilitation treatment and providing technical instructions for those who are considered disabled out-patients or those suffering from chronic diseases. However, owing to the scarcity of rehabilitation equipment and facilities, the community rehabilitation business is being dominated totally by TCM: acupuncture, moxibustion and massage. Thus, patients' needs can hardly be met.
After 1949, the 'socialist medical cooperation centers (SMCCs)' were established in urban and rural areas, and the health care personnel who served in these centers or paid house visits were known as 'bare-foot doctors'. Notwithstanding the ability of these centers to cover and deliver medical care to large areas, the bare-foot doctors' technical skills became out of date. However, with the country's economic development, the government started to lose control over the SMCCs because of decreased state funding, and the centers were forced to become individually owned or abandoned, which led to the disappearance of the bare-foot doctors. Between the gradual disappearance of the SMCCs and bare-foot doctors and the establishment of the CHC system, there was a transitional period of two decades (1978–1998) during which the rural areas suffered a severe lack of medical facilities; there were no private clinics. At the beginning of 1998, the government started to establish the CHC system, and in some locations the erstwhile SMCCs became clinics owned by individuals. Later, the central government started to fund these private clinics and demanded that they put their facilities and services at the disposal of their communities, by taking the role of CHCs and fulfilling their six main functions . However, before the Chinese economic reform policy was implemented, the CHCs were supported financially by the government and they delivered their services free of charge to all residents. By 2004, the Ministry of Health implemented a law known as the 'Medical Security System' targeting the peasants. According to this law, the central government funded the system with 10 RMB, the local government with 10 RMB, and each individual also contributed 10 RMB. By this method, the rural areas were able to establish a CHC in each community and peasants were obliged to obtain medical services from these centers, reducing the heavy patient load on hospitals, and maintain the financing of the CHCs. As the medical industry became channeled into market-oriented business, the government's investment in the CHCs gradually started to diminish, and this led to shrinkage of the CHC services, and some CHCs were even demolished or sold to individuals. However, the number of CHCs controlled by hospitals varies depending on the development of each city. In China, the CHCs are founded by different organizations or the private sector. Some are founded by the government, some by hospitals and others are set up by the private sector. For example, in Shanghai there are a total of 86 CHCs all founded by the government but are managed by hospitals. In Guangzhou, there are 106 CHCs, but 80 of them were established and managed by hospitals, and the other 25 CHCs are set up by the neighborhoods or private people. The CHCs' management is controlled by hospitals, which is a plus for these health institutions where they are able to attract many patients through different channels, and increasing their earnings. However, the commercial aspect towards managing the CHCs by hospitals is not in the benefit of these centers because hospitals are targeting and concentrating on attracting quantity rather emphasizing on delivering a quality service. Hence, the Guangzhou government has decided to permit all CHCs of becoming independent of hospitals' control, and in the future all the CHCs in Guangzhou will be set up and managed by the local governments and neighborhoods. As for Xiamen, there are 62 CHCs, and 50 of them are set up by the government. In Fuzhou, there are 85 CHCs and 60 are founded by hospitals. In Hangzhou, there are 95 CHCs and 60 are founded by hospitals. In Zhuhai, there are 80 CHCs and 60 are founded by the private sector. So, the local governments in these cities do not support a lot the CHCs with funds but rather these centers have to be run according to the governments' medical service rules.
In the last couple of years, people have started to complain about the government's health reform policy. For example, in 2005, the authoritative research institution in China – the Development Research Center of State Council P.R. China – released results indicating that the Chinese health reform program was not successful and failed overall to deliver an efficient and cost-effective health care service to its population. Therefore, the objective of the present study is to discuss the utilization of CHCs, compare them with local hospitals, and determine whether they can deliver appropriate basic medical and public health services [4, 6].