Residents’ Awareness of Family Doctor Contract Services, Status of Contract with a Family Doctor, and Contract Service Needs in Zhejiang Province, China: A Cross-Sectional Study

Xiaopeng Shang, Yangmei Huang, Bi’e Li, Qing Yang, Yanrong Zhao, Wei Wang, Yang Liu, Junfen Lin, Chonggao Hu and Yinwei Qiu
Additional contact information
Xiaopeng Shang: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Yangmei Huang: The Center for Disease Control and Prevention of Hangzhou City, Hangzhou 310021, China
Bi’e Li: Danzhou City Center for Disease Control and Prevention, Danzhou 571700, China
Qing Yang: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Yanrong Zhao: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Wei Wang: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Yang Liu: School of Public Health, Xiamen University, Xiamen 361102, China
Junfen Lin: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Chonggao Hu: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Yinwei Qiu: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China

IJERPH, 2019, vol. 16, issue 18, 1-14

Abstract: In China, family doctor services originated in 2009. After two years, the Chinese government proposed the establishment of a family doctor contract system suitable for China’s national conditions. Then, in 2016, a multi-department jointly issued an important document, which further clarified the development goals of family doctor contract services in the next five years. Zhejiang Province has been exploring responsible doctor contract services since 2012, which was promoted throughout the province in 2015. Objectives: The aim of this study was to investigate the residents’ awareness of Zhejiang Province, China, of family doctor contract services, the status of signing such a contract, and the demand for service items in the contracted service package. Further, we sought to explore the relevant influential factors in order to provide a reference and evidence-based recommendations for the further development of family doctor contract services. Design: We enrolled 3960 residents from nine counties in Zhejiang Province using a multistage stratified random sampling method. A survey using a self-designed questionnaire was used to collect the demographic data, residents’ awareness of family doctor contract services, the status of contracting, and demand for different items from October to December 2017. Data were analyzed by SPSS 21.0. Results: In total, 3871 residents returned valid questionnaires, with a response rate of 97.75%. The awareness rate of residents of family doctor contract services was 71.58% (2771/3871). Age, education level, and chronic medical history status were the influencing factors affecting residents’ awareness. The contracted rate was 50.43% (1952/3871). Age, education level, personal monthly income, chronic disease history, and awareness of family doctor contract services were the influencing factors. Residents who have a contract with family doctors have a higher demand for family doctor contract services, and different residents have different needs for the project because of their physical condition, education level, marital status, household registration, and personal monthly income level. The top three needs of the residents for contracted services were health consultation (84.64%), regular physical examination (81.71%), and increasing the proportion of medical insurance reimbursements (80.06%). Conclusions: The awareness rate of family doctor contract services and the contracting rate are unsatisfactory among residents of Zhejiang Province. It is suggested that the government should more heavily publicize family doctor contract services, expand the coverage, introduce personalized contract schemes to meet the needs of different groups, and promote the rapid development of family doctor contract services in Zhejiang Province.

Keywords: family doctor contract services; awareness; demands; health care reform; Zhejiang Province (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5)

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