Do Residents and Healthcare Providers Differ in Preference for Family Doctor Contract Service? Evidence From a Discrete Choice Experiment.

Jiao Zhang,Aijun Xu,Lingzhong Xu,Wenzhe Qin

doi:10.3389/fpubh.2022.800042

Abstract

ObjectiveFew are known on how and to what extent residents and healthcare providers have different preferences for family doctor contract service (FDCS). This study aimed to elicit and compare the residents' and healthcare providers' preferences for FDCS through a discrete choice experiment (DCE).MethodsResidents and healthcare providers recruited for the DCE were asked to choose repeatedly between two hypothetical service plans, which differed in six attributes: cost, service package, service delivery, type of service, accessibility of medicine, and level of healthcare team. We use mixed logit regression models to determine preferences for potential attributes.ResultsA total of 2,159 residents and 729 healthcare providers completed valid DCE questionnaires. The mixed logit model results suggested that cost, service package, service delivery, type of service, accessibility of medicine, and level of healthcare team all had a significant impact on residents' and healthcare providers' preference. The level of healthcare team was the most important characteristic of FDCS to both residents and healthcare providers, followed by types of service. They have different preferences on the cost and way of service delivery.ConclusionsThis study provides new evidence on how and to what extent residents and healthcare providers have different preferences for FDCS by determining their perception of various service attributes. These findings suggested that the optimal design and improvement of FDCS plans should consider not only residents but also healthcare providers' preferences to maximize contract service uptake.

Highlights

General practice is regarded by the World Health Organization as the most economical and appropriate healthcare service model
The residents had a mean age of 63.06 years (SD = 10.76), the majority of them were women (58.04%), and 66.33% lived in rural area
Our study showed that cost of service, service package, way of service delivery, type of service, accessibility of medicine, and level of healthcare team all influenced residents’ and healthcare providers’ preferences for family doctors contract service (FDCS), which provides new insights on how residents and healthcare providers value attributes associated with FDCS from their different perspective

Summary

Introduction

General practice is regarded by the World Health Organization as the most economical and appropriate healthcare service model. International experience has proved that the promotion of family doctors contract service (FDCS) is an important way to strengthen the primary healthcare system and protect and maintain people health. Previous studies have shown that the implementation of FDCS has generally improved the effectiveness of self-management in health [4] and primary care quality [5]. Some researchers have noted that both the actual signing rate and utilization rate of FDCS are far from the national target in China and need to be improved. A meta-analysis study from Li et al [6], for example, showed that the signing rate of FDCS for Chinese residents was 46.2% (95%CI: 35.5–56.9%). The important prerequisite for this is to clarify the preferences for FDCS from the perspective of residents (demander) and healthcare providers (supplier) [9]. Evidence is unclear cut on how and to what extent residents and healthcare providers have different preferences

Methods

Results

Discussion

Conclusion