Abstract
BackgroundThe family doctor system has developed rapidly all over the world, and in the past few years, China has actively explored family doctor-type contracted services. This study aimed to explore the related factors of Contracted Family Doctors Services (CFDS) from the perspectives of medical staff and consumers, and to provide a stronger basis for the development and promotion of CFDS.MethodsA combination of quantitative and qualitative methods were used in this study. A self-reported questionnaire was designed through a literature analysis, group discussions, expert consultations and a pre-investigation, and conducted among community health service providers in 12 community health service centres across four provinces of China. A total of 389 participants participated, and 320 valid questionnaires were obtained, with an effective response rate of 82.3%. A total of 36 consumers participated in in-depth interviews, and the effective rate was 100.0%. An exploratory factor analysis, a confirmatory factor analysis, inductive methods, and expert consultations were used to analyse the related factors of CFDS.ResultsThe related factors of CFDS from the perspectives of medical staff were divided into four dimensions, with the following weighting coefficients: national government factors (31.9%), community health service agency factors (24.7%), consumer-related factors (22.6%), and contracted doctor-related factors (20.8%). The related factors of CFDS from the perspectives of consumers were divided into four dimensions, with the following frequency sequence: national government factors, contract doctor-related factors, community health service agency factors, and consumers-related factors. National government factors played an important role in CFDS from the perspectives of medical staff and consumers.ConclusionsThe related factors of CFDS were the same from the perspective of medical staff and consumers, but the weight of each factor was different. The development of CFDS is inseparable from the support of policies. It is suggested that the government should strengthen the publicity of CFDS, expand the coverage, introduce personalised contract programs that meet the needs of different groups, and promote the rapid development of CFDS.
Highlights
The family doctor system has developed rapidly all over the world, and in the past few years, China has actively explored family doctor-type contracted services
The experts deemed that the ‘situation of the first diagnosis of the patients/consumers’ should be incorporated into the residentrelated factors dimension rather than contracted doctor-related factors
The related Contracted Family Doctors Services (CFDS) factors from the perspective of medical staff were divided into four dimensions and 25 items
Summary
The family doctor system has developed rapidly all over the world, and in the past few years, China has actively explored family doctor-type contracted services. According to a World Health Organization report, the proportion of all patients with diseases requiring specialized medical treatment was only about 5%, and more than 90% of health problems could be effectively solved by professionally trained general practitioners [2]. The role of general practitioners/ family doctors, according to the World Organization of Family Doctors, is to provide comprehensive health care services and to arrange for other health professionals to provide related services when necessary [3]. The family doctor system originated in the United States in the 1960s [5], when the government integrated health management into the community general practitioner service model [6]. Active follow-up observations were performed on patients with chronic diseases and during the rehabilitation period [6]
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