Factors Associated with Rural Residents’ Contract Behavior with Village Doctors in Three Counties: A Cross-Sectional Study from China

Linni Gu, Rui Zhu, Zhen Li, Shengfa Zhang, Jing Li, Donghua Tian and Zhijun Sun
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Linni Gu: Business School, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing 100875, China
Rui Zhu: China Academy of Social Management/School of Sociology, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing 100875, China
Zhen Li: Business School, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing 100875, China
Shengfa Zhang: School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing 100875, China
Jing Li: School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing 100875, China
Donghua Tian: School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing 100875, China
Zhijun Sun: Business School, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing 100875, China

IJERPH, 2020, vol. 17, issue 23, 1-13

Abstract: Historically, cooperative medical insurance and village doctors are considered two powerful factors in protecting rural residents’ health. However, with the central government of China’s implementation of new economic policies in the 1980s, cooperative medical insurance collapsed and rural residents fell into poverty because of sickness. In 2009, the New Rural Cooperative Medical Insurance (NRCMI) was implemented to provide healthcare for rural residents. Moreover, the National Basic Drug System was implemented in the same year to protect rural residents’ right to basic drugs. In 2013, a village doctor contract service was implemented after the publication of the Guidance on Pilot Contract Services for Rural Doctors . This contract service aimed to retain patients in rural primary healthcare systems and change private practice village doctors into general practitioners (GPs) under government management. Objectives: This study investigates the factors associated with rural residents’ contract behavior toward village doctors. Further, we explore the relationships between trust, NRCMI reimbursement rate, and drug treatment effect. We used a qualitative approach, and twenty-five village clinics were chosen from three counties as our study sites using a random sampling method. A total of 625 villagers participated in the investigation. Descriptive analysis, chi-squared test, t -test, and hierarchical logistic analyses were used to analyze the data. Results: The chi-squared test showed no significant difference in demographic characteristics, and the t -test showed a significant difference between signed and unsigned contract services. The results of the hierarchical logistic analysis showed that trust significantly influenced patients’ willingness to contract services, and the drug treatment effect and NRCMI reimbursement rate moderated the influence of trust. Conclusion: Our findings suggest that the government should aim to strengthen trust in the doctor–patient relationship in rural areas and increase the NRCMI reimbursement rate. Moreover, health officers should perfect the contract service package by offering tailored contract services or expanding service packages.

Keywords: village doctor contract service; NRCMI; trust; reimbursement rate; drug treatment effect; family doctor; rural area (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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