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Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

PLoS One · 2018 · PMC5965823 · PMID 29791470

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an increasing trendno p-value reported
During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.