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6% (OR, 0.814; 95% CI, 0.764-0.867) in 2014, 30.0% (OR, 0.700; 95% CI, 0.657-0.745) in 2016, and 34.9% (OR, 0.651; 95% CI, 0.611-0.694) in 2018. The decrease was significantly associated with the changes in residents' health status. The residents' likelihood of choosing PHC service represented a decreasing trend, which was contrary to the objective of China's National Health Reform in 2009. We recommend that policymakers adjust the primary service items in PHC facilities and strengthen the coordination of service between PHC institutio
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