Abstract
BackgroundFamily doctor policy is an important part of deepening healthcare reform in China. The study aimed to explore the association between cardiovascular-metabolic multimorbidity and the status of signing a contract for family doctor services among the older people in rural Shandong, China.MethodsA cross-sectional study was conducted in 3 cities of Shandong province, China. A total of 1395 rural residents over 60 years of age were included in this study using a multistage stratified random sampling method. Covariates included demographic and socioeconomic characteristics, health-related characteristics, health service utilization, and awareness of family doctor contract services. The univariate and multivariate regression logistic analysis was used to analyze the data.ResultsThere were 28.2% of the rural older people contracted for the family doctor contract services. The contract rate of seniors with cardiovascular-metabolic multimorbidity was statistically higher than those without cardiovascular-metabolic multimorbidity (OR = 1.67, 95%CI, 1.21-2.32) after controlling for confounding factors. In addition, occupation, physical activities, self-rated health status, distance from the village clinic, the awareness of family doctor contract services were found to be associated with the signing behavior among the rural older adults.ConclusionThis study demonstrated that the rural older people with cardiovascular-metabolic multimorbidity had a higher family doctor contract rate than those without cardiovascular-metabolic multimorbidity, and there was a gap between the current signing rate and the policy goal. To increase the rate of signing for family doctor contract services, the government should take joint efforts to expand the publicity and coverage, and give priority to meeting the healthcare demands of rural older adults with cardiovascular-metabolic multimorbidity.
Highlights
IntroductionThe study aimed to explore the association between cardiovascular-metabolic multimorbidity and the status of signing a contract for family doctor services among the older people in rural Shandong, China
Doctor policy is an important part of deepening healthcare reform in China
A study from Changning district in Shanghai, China, found that there were 61.8% of residents know about Family doctor contract services (FDCSs), and another study showed that the awareness rate reached 61.7% [30, 31], which were both higher than the result of our study (41.8%)
Summary
The study aimed to explore the association between cardiovascular-metabolic multimorbidity and the status of signing a contract for family doctor services among the older people in rural Shandong, China. Doctor contract services (FDCSs) policy was adopted to provide healthcare services and health management for the whole population by signing agreements with residents’ families [1]. It is based on the principles of. In China, family doctor team provide the basic healthcare services to those residents who have signed FDCSs contract. The older people and residents with chronic diseases are the main priority subgroups in contracting for family doctor services [5]. The doctor team in rural area serves as the “gatekeeper” of residents’ health and the executor of FDCSs policy, the key groups are further targeted and managed by them [5]
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