Abstract
BackgroundIn China, some previous studies have investigated the signing rate and willingness of residents to sign the family doctor contract services (FDCS). Few studies have explored residents’ willingness to renew the FDCS. This study is designed to understand the family characteristics difference towards rural households’ willingness of maintaining the FDCS.MethodsA total of 823 rural households were included in the analysis. A descriptive analysis was conducted to describe the sample characteristics. The binary logistic regression model was used to explore the family characteristics that influence the renewal willingness for FDCS among rural households in Shandong province, China.ResultsOur study found that about 95.5% rural households had willingness to maintain the FDCS in Shandong, China. Those households with catastrophic health expenditures (CHE) (OR = 0.328, 95%CI = 0.153–0.703), with highest level of education at graduate or above (OR = 0.303, 95%CI = 0.123–0.747) were less willing to maintain the FDCS. Those whose households have more than half of the labor force (OR = 0.403, 95%CI = 0.173–0.941) and those households living in economically higher condition were less willing to maintain the FDCS.ConclusionsThis study demonstrates a significant association between family characteristics (CHE, highest education in households, proportion of the household labor force) and willingness to maintain FDCS among rural households in Shandong, China. Targeted policies should be made for rural residents of identified at-risk families.
Highlights
The declaration of Alma Ata in 1978, issued by the WHO, emphasized the significant of primary healthcare (PHC) in strengthening the health systems of all countries [1]
In 2009, China launched a new round of health system reform, in which strengthening the construction of the PHC system was one of key measures [2]
2 counties were randomly selected from each city, and 5 townships were randomly selected from each county, 5 villages were randomly selected from each township, and 16 households were randomly selected from each village for this study by using random numbers
Summary
The declaration of Alma Ata in 1978, issued by the WHO, emphasized the significant of primary healthcare (PHC) in strengthening the health systems of all countries [1]. Doctor contract services (FDCS) aims to provide comprehensive health management services. From the perspective of residents’ health needs, family doctors provide comprehensive and whole-process health services and manage the health of residents within their jurisdiction by means of contracts, in accordance with the principles of informed, voluntary and family units and free choice [4]. In May 2016, the State Council’s Medical Reform Office, the National Health Commission, the National Development and Reform Commission, and seven other departments jointly issued the Guiding Opinions on Promoting Family Doctor Contract Services [5], China has begun to promote contracts with general practitioner services on a large scale. In China, some previous studies have investigated the signing rate and willingness of residents to sign the family doctor contract services (FDCS). This study is designed to understand the family characteristics difference towards rural households’ willingness of maintaining the FDCS
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