Health Service Institutions Research Articles

Patient Satisfaction at Aisyiyah RSU Klaten

Patient satisfaction in hospital services can also be achieved from the service system provided by the hospital. Hospitals as health service institutions are required to provide fast, quality and affordable services to provide satisfaction for patients. The purpose of this study is to determine the influence of waiting time, service quality, officer attitude and information technology on patient satisfaction at Aisyiyah Klaten Hospital. The method of this research is quantitative descriptive. The number of research respondents was 120, which was determined by accidental sampling technique. The results of the study showed that waiting time (p value 0.000), officer attitude (p value 0.008) and information technology (p value 0.015) had a positive and significant effect on patient satisfaction in health services at RSU 'Aisyiyah Klaten.The quality of service (p value 0.775) had no effect on patient satisfaction in health services at RSU 'Aisyiyah Klaten. The suggestion of this research is that information technology should be better and easily accessible so that patient satisfaction increases so that the quality of hospital services is even better. Keywords: satisfaction, service quality, officer attitude, information technology, waiting time

Large scale public health system transformation: Germany

Abstract The COVID-19 pandemic was a stress test for public health services in Germany. Decision making was complex (party lengthy and inconsistent) due to the divided responsibilities within the federal system. Some improvements on the public health system were already enacted during the pandemic. A “pandemic radar” was established to bundle up relevant infectious disease indicators with indicators of health services use. The national electronic notification and information system for infectious diseases was extended. Digital improvements were made in the public health offices. Laboratory capacity was strengthened, so was inter-science modelling to forecast pathogen spread. A nation-wide collaborative mechanism, the cloverleaf system, was introduced between regions to avoid the overburdening of hospitals. It is now established for times of excess need for inpatient services. In 2020, a 4 billion euros investment program, the “Pact of Public Health Services”, was adopted to strengthen and modernize the German public health service institutions. The pact is implemented until 2026. The human resources component is the largest. Further priorities include digitalization, improvement of the infrastructure (of designated ports and airports) for the implementation of the International Health Regulations, research and the creation of agile and resilient public health structures. Outputs so far include the establishment of more than 4800 new public health positions, the appointment of new professorships for public health services, the initiation of several research projects, and the roll-out of more than 300 digitalization projects. A new federal institute for prevention is planned. It aims to foster networking between public health services, strengthen health communication, data use, and evidence for public health services. In this process, WHO advised the federal ministry e.g. on behavioral insights; heat health action; prevention on noncommunicable diseases and others. Many public health actors have provided opinions. However, consensus building on how Germany can overcome fragmentation in public health is ongoing.

Constructing a Competency Training Index System in Public Health Emergencies for Community Nurses.

A competency training index system was designed in public health emergencies for community nurses. The purpose of this approach is to provide community nurses with guidelines for standardized training programs on how to respond to public health emergencies. Through semi-structured interviews, a literature review, and team discussion, the first draft of competency training index system in public health emergencies for community nurses was formed. The Delphi method was used for two rounds of expert consultation to screen, modify and determine indicators. Finally, the analytic hierarchy process was utilized to calculate the weights of indicators at all levels. A total of 15 expert consultants were included. The effective recovery rate of the two rounds of expert consultation questionnaire was 100%, the expert authority coefficient was 0.880, 0.887, and the Kendall coordination coefficient was 0.172 and 0.171 (p < 0.001). Expert opinions have determined that the final revised competency index system in public health emergencies for community nurses training consists of 2 primary indicators, 10 secondary indicators, and 46 tertiary indicators. The study has developed a competency training index system in public health emergencies for community nurses. This system can serve as a foundation for standardized training in community health service institutions. It is characterized by its high demand, scientific approach, reliability, and rationality.

Analysis of blood glucose control and influencing factors in 18-64 year-old community people with type 2 diabetes in Shenzhen

Objective: To describe the current situation of blood glucose control in 18-64 year-old people with type 2 diabetes in the Shenzhen community and analyze the influencing factors to provide a reference for enhancing the management effect of type 2 diabetes in community health service institutions. Methods: The data were from the Shenzhen Community Health Service Information System. A cross-sectional survey design was adopted to include 18-64 year-old patients with type 2 diabetes in Shenzhen community health service institutions in 2022. The blood glucose control rate was calculated through the physical examination data recorded by the information system in 2022, and the influencing factors of blood glucose control in this group of patients were analyzed using a multivariate logistic regression model. Results: A total of 120 174 patients were included in the study. The blood glucose control rate was 53.04%. The results of multivariate logistic regression analysis showed that women (OR=1.07, 95%CI: 1.04-1.10), ages 45-54 (OR=1.10, 95%CI: 1.01-1.19), 55-64 (OR=1.24, 95%CI: 1.14-1.35), middle school (OR=1.09, 95%CI: 1.05-1.13), high school and technical secondary school (OR=1.26, 95%CI: 1.21-1.31), junior college or above (OR=1.75, 95%CI: 1.67-1.83), basic medical insurance for urban employees (OR=1.05, 95%CI: 1.01-1.08), weekly exercise (OR=1.26, 95%CI: 1.22-1.31), daily exercise (OR=1.31, 95%CI: 1.28-1.35) and combined hypertension (OR=1.21, 95%CI: 1.18-1.24) were more likely to reach the standard of blood glucose control; while unmarried (OR=0.85, 95%CI: 0.77-0.95), divorced (OR=0.84, 95%CI: 0.73-0.97), insurance status was fully self-funded (OR=0.95, 95%CI: 0.91-0.99), disease duration was 5- years (OR=0.65, 95%CI: 0.63-0.66), ≥10 years (OR=0.41, 95%CI: 0.39-0.42), the treatment method was diabetes drug therapy (OR=0.74, 95%CI: 0.71-0.76), low weight (OR=0.89, 95%CI: 0.80-1.00), obese group (OR=0.85, 95%CI: 0.82-0.88), combined with central obesity (OR=0.83, 95%CI: 0.81-0.86), combined with dyslipidemia (OR=0.69, 95%CI: 0.68-0.71), current smoking (OR=0.74, 95%CI: 0.72-0.77), and current drinking (OR=0.97, 95%CI: 0.93-1.00) were less likely to reach the standard of blood glucose control. Conclusions: The blood glucose control rate of 18-64 year-old people with type 2 diabetes in Shenzhen still has room for improvement. More attention should be paid to 18-64 year-old patients with type 2 diabetes, especially for patients with dyslipidemia, central obesity, and diabetes with a long course, and supervision and guidance should be strengthened for patients with bad habits such as smoking, drinking alcohol, and lack of exercise.

Perancangan Sistem Informasi Pengolahan Data Rekam Medis Elektronik Guna Menunjang Tata Kelola Pelaporan Rawat Jalan

Recording and reporting medical records is the main activity in health service institutions, and hospital information systems play an essential role in this process. Outpatient data processing at XYZ Hospital uses spreadsheets and Google Sheets even though it has yet to implement SIMRS fully. Because the data in the SIMRS must be changed for each spreadsheet report, there are several reporting problems. Therefore, the authors begin to develop a web-based outpatient reporting system after researching the need for more efficient applications. This study uses a qualitative approach to data collection through interviews and observations, focusing on developing a waterfall software. The results showed that searching and managing patient data and making outpatient recapitulation reports became easier for medical record officers. Implementing this system brings several concrete impacts, including reducing human errors in data recording, increasing the speed of access to medical information, and increasing time efficiency in making reports. This system also allows better data integration between hospital departments, improving patient care coordination and the overall quality of health services.

A generalized behavioral-based goal programming approach for decision-making under imprecision

The body of literature on goal programming (GP) approaches in modeling preferences and the satisfaction philosophy in multi-objective programming (MOP) decision-making processes is extensive. However, there has been little focus on how preferences change in relation to the decision-maker's (DM) behavior within this satisfaction philosophy, particularly in situations involving risk. To address this challenge, we propose introducing a behavior-type utility function into the GP model using the concept of a behavior function. This idea offers an innovative perspective for modeling DM's behavioral preferences in the imprecise GP approach by integrating a risk-aversion parameter specific to each objective. We then formulate a generalized behavioral-based GP approach for decision-making based on this new behavior-type utility function. To validate our proposed approach, we present an illustrative example of project selection in health service institutions, followed by a sensitivity analysis and comparisons with other approaches. The results demonstrate that DM's behavioral preferences significantly impact the decision-making process, and the proposed model provides more reasonable and convenient decisions for DMs with varying degrees of risk aversion.

Uji stabilitas penyimpanan RC A amlodipine dengan metode kromatografi cair tingkat tinggi

Background: One of the important components of health is the availability of drugs as part of public health services. This is because drugs are used to save lives, restore or maintain health. The pharmaceutical industry as a drug-producing industry has a strategic role in health service efforts to the community. Findings: Along with increasing education and public awareness of the importance of health, the pharmaceutical industry is required to provide drugs in adequate types and quantities and of good quality. Therefore, public access to drugs including availability and affordability for the entire community must be expanded. Access to drugs, especially essential drugs, is an obligation for the government and health service institutions, both public and private. Methods: Add with mobile phase to the limit mark, then homogenize (Solution S1 0.04 mg/ml). The solution to be tested for stability during the RC A Amlodipine area is stable. Storage is carried out in dark glass bottles and stored in a refrigerator at a temperature of 2-8 °C. Conclusion: This indicates that each new batch analysis can use the RC Amlodipine stock for a period of 4 months with a storage temperature of 2-8 °C. In this study, RC A Amlodipine which was weighed before the study each time the test was carried out was weighed once and made into a stock solution for 4 months. This study also carried out the potential for cost saving because every year 3 bottles are now 1 bottle, which is 96.5%.

PATIENT SATISFACTION AT AISYIYAH RSU KLATEN

Patient satisfaction in hospital services can also be achieved from the service system provided by the hospital. Hospitals as health service institutions are required to provide fast, quality and affordable services to provide satisfaction for patients. The purpose of this study is to determine the influence of waiting time, service quality, officer attitude and information technology on patient satisfaction at Aisyiyah Klaten Hospital. The method of this research is quantitative descriptive. The number of research respondents was 120, which was determined by accidental sampling technique. The results of the study showed that waiting time (p value 0.000), officer attitude (p value 0.008) and information technology (p value 0.015) had a positive and significant effect on patient satisfaction in health services at RSU 'Aisyiyah Klaten.The quality of service (p value 0.775) had no effect on patient satisfaction in health services at RSU 'Aisyiyah Klaten. The suggestion of this research is that information technology should be better and easily accessible so that patient satisfaction increases so that the quality of hospital services is even better. Keywords: satisfaction, service quality, officer attitude, information technology, waiting time

Hubungan Shift Kerja dengan Kelelahan Kerja pada Radiografer di Rumah Sakit Umum Daerah Teluk Kuantan

A hospital is a health service institution that operates 24 hours a day. The service is divided into several sections, one of which is the medical support section, including radiology. Radiology workers are referred to as radiographers. In carrying out their duties, the radiographer cannot be separated from the work shift system, at the Teluk Kuantan Regional General Hospital applying morning shifts (07.00-14.00), afternoon (14.00-20.00) and night (20.00-08.00). Shift work time from morning, afternoon and evening can result in work fatigue. The purpose of this study was to see whether there is a relationship between work shifts and work fatigue on radiographers at the Teluk Kuantan Regional General Hospital. This research is a type of quantitative research that is analytic in nature with a cross sectional design through library research, field observations, questionnaires / questionnaires distributed to respondents. This research was carried out at the Radiology Institute of the Kuantan Bay Regional General Hospital from April to June 2022. The results of this study can be known by distributing questionnaires after which the data is processed using univariate and bivariate (Chi-Square) tests. Based on the bivariate test (Chi-Square) it is known that the value of p (value) = 0.003 where p (value) &lt;0.05, meaning that there is a relationship between work shifts and the occurrence of fatigue in radiographers at the Teluk Kuantan General Hospital.

A community proactive health management model for family doctors in Shandong, China.

Background Chronic disease management is an essential part of public health management and a fundamental means of slowing down the progression of major diseases. Unlike traditional medical care, proactive health management focuses on the combination of prevention and treatment. Proactive health management can reduce the re-admission rate of patients with chronic diseases, improve long-term prognosis, and effectively reduce the disability and mortality rates of major health events. This study aimed to establish a proactive health management model based on a grid-based medical service team arrangement, and to explore the effect of this model on managing chronic diseases in community health service institutions. Methods A grid-based medical service team was established in Binzhou, Shandong, China, consisting of general practitioners, nurses, public health doctors, health promoters and community grid liaison staff. Each team was responsible for several areas to monitor critical populations within the grid and compile statistics on the health management of these key populations in 2022-2023. Results A total of 2050 patients with coronary artery disease, 4973 patients with hypertension, and 1621 patients with type 2 diabetes were followed up in 2022. Compared with 155,612 resident health records in 2022, the number of records increased by 140.50% in 2023. The number of patients with hypertension under health management in 2023 increased by 50.92%; patients with type 2 diabetes increased by 74.65%; and the number of coronary artery disease increased by 42.00%. After the implementation of grid management, the hospitalisation rate for patients with type 2 diabetes significantly decreased in 2023 (P P >0.05). Conclusion The grid-based community proactive health management model makes full use of the advantages of community resources and improves the pertinence and coverage of community health services. Moreover, it reduces hospitalisation for patients with type 2 diabetes.

EFFECTIVENESS OF ADMINISTRATIVE SERVICES AT ANANDA BEKASI HOSPITAL CONCERNING THE LEVEL OF PATIENT OR COMMUNITY SATISFACTION

As a health service institution such as a hospital, its responsibility is to provide services that meet the health needs of the community. Quality service health own roles important in increase health and well-being whole public. The aim of this research is to examine the effectiveness of administrative services at Ananda Bekasi Hospital and its impact on the level of community satisfaction. Through a comprehensive approach, this research evaluates hospital administration processes, including the registration process, patient data management, and communication with patients. Data was collected through interviews and observations to measure public perceptions of administrative services. The method used is by analyzing data to understand the contributing factors to levels satisfaction community as well as recommendations for improvements that can be made by Ananda Bekasi Hospital. Research results indicated that effectiveness service administration at Bekasi City Hospital had an impact positive to levels satisfaction public.

Analysis on the willingness and influencing factors of choosing hospice care service institutions among among older people in Wuhu, China: a cross-sectional study

ObjectiveThe purpose of this study was to evaluate the inclination and determinants influencing the selection of hospice care service institutions among elderly individuals in China.DesignThe study conducted has a cross-sectional...

Audit Rekam Medis dalam Upaya Peningkatan Kualitas Pengisian Rekam Medis di RSUD Sleman

A hospital is a health service institution that provides complete individual health services for inpatient, outpatient, and emergency care. Hospitals as health service providers are required to maintain medical records. The administration of medical records for each hospital refers to the Regulation of the Minister of Health of the Republic of Indonesia. A medical record audit is needed to determine the completeness of data in medical records both in quantity and quality. The purpose of this study was to determine the medical record audit at RSUD Sleman. The type of research used is analytic observational with a cross-sectional study design. This research was conducted at RSUD Sleman, Special Region of Yogyakarta. The research was done from April to October 2022, during a period of 7 months. Simple random sampling was used to collect data from 94 medical records. The audit of 94 samples of medical records resulted in the following findings: completeness, patient identity 100%, professional identity in providing care 99.01%, date and time 70.21%, initial assessment 90.42%, subjective examination 98.84%, objective examination 66.01%, management plan 91.49%, clinical pathology examination 58.51%, radiological examination 75.53%, primary diagnosis 100%, secondary diagnosis 100%, and general agreement 100%. The lowest percentage of 58.51% was obtained for incomplete data.

Tinjauan Pemanfaatan Data Sensus Harian Rawat Inap

A hospital is a health service institution that provides plenary individual health services that provide inpatient, outpatient, and emergency services. (Dzulhidayat, 2022). Minister of Health of the Republic of Indonesia number 24 of 2022 Medical Record is a document that contains patient identity data, examinations, treatment, actions, and other services that have been provided to patients.The daily inpatient census is a routine activity carried out in hospitals that counts the number of patients served in the inpatient unit. The daily inpatient census is conducted from 00:00 to 24:00 by officers in the care ward. The ward officer counts the number of incoming patients, outgoing patients, transferred or transferred patients, deceased patients and days of patient care. . The data will be recapitulated every month and used as statistics on hospital services that will be reported to the authorities. (Garmelia et al., 2018). The method in this research is a literature study, where this research is carried out with a data set technique to study books A literature search of records and reports related to research with the results obtained still found the implementation of the daily census of hospitalizations that are still delayed due to inadequate human resources In the absence of socialization to fellow officers, SOPs governing the daily census have not been implemented properly. This is why most of the daily census process of hospitalizations has not been well implemented

PENGARUH TARIF RAWAT INAP DAN STANDAR PELAYANAN MINIMAL TERHADAP KEPUASAN PASIEN BPJS DI RUMAH SAKIT SILOAM PURWAKARTA

Effect of Inpatient Rates and Minimum Service Standards on BPJS Patient Satisfaction at Siloam Hospital Purwakarta.Based on optimal Service delivery, a health Service institution provides an impetus for the government to make a regulation regarding equitable standards in the health Service system. This study aims to determine how the influence of minimum Service rates and standards in Siloam Purwakarta hospitals in accordance with existing regulations.The analytical framework used is the inpatient tariff framework and minimum Service standards for patient satisfaction evaluating comfort, patient relationships, staff technical competencies and costs. The analytical method used is descriptive analysis with a quantitative approach.The results of the analysis show (1) Effect of Inpatient Rates on Patient Satisfaction partially has a significant influence on patient satisfaction (2) Effect of Minimum Service Standards on Patient Satisfaction partially has a significant effect on patient satisfaction (3) Effect of Inpatient Rates and Standards Minimal Service to patient satisfaction simultaneously has a significant effect on patient satisfaction and has an influence of 90.6% and the remaining 9.4%&gt; is influenced by other factors not examined. The suggestions given by the authors include: (1) It should be noted again about BPJS hospitalization rates and re-socialization about class promotion programs, namely by analyzing the making of hospitalization rates and making special fields for Information on Service rates. (2) Need to continuously provide an explanation or understanding to patients of the minimum Standard of hospitalization. (3) Due to the simultaneous influence between inpatient rates and minimum Service standards on patient satisfaction, the quality of the two variables must be reviewed.

The Importance of Human Resources in the Accreditation Process of Health Service Institutions

In the study, the contribution of the human resources working in the health care organisations in the accreditation process and their impact on this process will be measured. The data collection tool, El-Jardali et al. (2008), to assess staff perceptions of the impact of accreditation on service quality and other factors affecting service quality, was adapted to be administered to all staff in the health facility with an accreditation certificate. For statistical analysis, descriptive statistics, one-way analysis of variance (ANOVA), Pearson correlation analysis and Tukey HSD test as post-hoc test were used in SPSS 22.0 programme, and multiple regression analyses were used to determine the relationship between the dependent variable and the independent variables. As a result of the research, it was found that the level of employees' agreement with the statements in the subscales 'Employee Involvement' and 'Recognition and Appreciation' differed professionally between the groups of nurses, midwives and doctors. In addition, it was found that the level of agreement with the statements in the Leadership, Commitment and Values sub-scales differed between all the groups.

Diagnostic Options for Suspected Cases of Emotional Maltreatment - Presentation of the Interdisciplinary Perspective of a Child Protection Outpatient Clinic

Compared to sexual and physical violence, cases of emotional abuse are often more difficult to detect. An increasingly advocated approach involves regular assessments within social and healthcare structures tto proactively identify affected children and adolescents at an early stage. This enables the prompt initiation of appropriate interventions. Following, interdisciplinary institutions such as a child protection outpatient clinic can play an important role for professionals in the clarification of suspected child endangerment.This article aims to show possible courses of action for the early detection of emotional abuse based on a child protection outpatient clinic. In addition to the description of the interdisciplinary diagnostic procedure a selection of psychometric questionnaires and interviews is presented, which inquire about emotional abuse. When looking at the total number of 1,388 cases seen at the child protection outpatient clinic, it is noticeable that only 117 cases (8.4 %) were assigned with a suspicion of emotional abuse.This contrasts with 477 cases (34.3 %) in which confirmed indications for emotional abuse were found after the clarification process. An intersection of emotional abuse with other forms of child maltreatment was given in 341 cases (71.4 %). Psychometric questionnaires and interviews can facilitate a regular recording in health and social service institutions. Emotional abuse often goes unnoticed despite its frequency. Itsmanifestations are diverse and significantly overlap with other forms of maltreatment, necessitating a nuanced evaluation process. Specific diagnostic tools and interdisciplinary collaboration can contribute to better recognition of emotional abuse.

Development of the EVIBEC Learning Outcomes Framework to support the delivery of evidence-based practice curricula in health care professional programmes: a codesign approach

BackgroundAll healthcare professional education programmes must adopt a systematic approach towards ensuring graduates achieve the competencies required to be an evidence-based practitioner. While a list of competencies for evidence-based practice exist, health care educators continue to struggle with effectively integrating the necessary competencies into existing curricula. The purpose of this project was to develop an open access cross-discipline, learning outcomes framework to support educators in integrating the teaching, learning and assessment required to ensure all graduates of health care professional programmes can achieve the necessary evidence-based practice competencies.MethodsAn interdisciplinary team of health care professional educators and a librarian completed a review of the health professions literature on the teaching and assessment of evidence-based practice. The literature, coupled with the teams’ collective experiences in evidence-based education and research, were used to identify relevant teaching, learning and evidence-based competency frameworks to inform the project design. The guide and toolkit for experience-based co-design developed by the National Health Service Institute for Innovation and Improvement was adopted for this study ( Institute for Innovation and Improvement: Experience Based Design: Guide & Tools In. Leeds: NHS; 2009.). A four-step approach involving three online participatory co-design workshops and a national validation workshop was designed. Students (n = 33), faculty (n = 12), and clinical educators (n = 15) participated in formulating and mapping learning outcomes to evidence-based competencies. ResultsThrough a rigorous, systematic co-design process the Evidenced-based Education Collaborative (EVIBEC) Learning Outcomes Framework was developed. This framework consists of a series of student-centred learning outcomes, aligned to evidence-based practice competencies, classified according to the 5 As of EBP and mapped to the cognitive levels of Bloom’s taxonomy. Associated learning activities for each step of EBP are suggested. ConclusionsA consensus-based, student-centred learning outcomes framework aligned to a contemporary set of EBP core competencies has been developed. The freely accessible EVIBEC framework may support entry level health care professional EBP education, by informing EBP curriculum development and offering the potential for interdisciplinary approaches to and sharing of valuable teaching and learning resources. Co-design proved an effective method in creating and refining this framework.

E-Booklet media can increase teenagers' knowledge about breast self-examination

Breast cancer in women is the highest number of cancer cases in the world. Adolescents aged 10-21 years with breast cancer are often found at an advanced stage. This incident was caused by the low knowledge of teenagers about early detection of breast cancer with BSE. This research aims to determine the effectiveness of e-booklet media in increasing young women's knowledge regarding breast self-examination (BSE). This research is quantitative with a pre-experiment research design with a pre-test and post-test design without a control group design. The sampling technique in this research uses a probability sampling technique with a Simple Random Sampling approach. The sample consisted of 81 respondents who were high school students in DKI Jakarta. The research results showed an increase in the average knowledge score of young women after being given the E-Booklet media about BSE with a p-value &lt; 0.001. Health service institutions and schools can utilize E-Booklet media during health education, especially for young women regarding BSE.

Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies.

A number of studies have investigated the influencing factors regarding the renewal of contracts associated with Family Doctor Contract Services (FDCS) in different regions of China since it was officially implemented in 2009; however, none of the previous studies have been considered using a nationally representative sample in combination with a meta-analysis. A multistage stratified sampling method was used to investigate participants' socio-demographic characteristics, health status, understanding, use, and evaluation of the FDCS, and their willingness to renew contracts in Eastern, Central, and Western China from September to November 2021. We searched the PubMed, Ovid Medline, CNKI, VIP, Wanfang, and SinoMed databases to retrieve previous studies related to the willingness of Chinese residents to renew contracts with their family doctor (FD), and a meta-analysis was performed to systematically summarize the willingness to maintain contracts and influencing factors. Among 2,394 residents, 2,122 (88.64%) were willing to renew their contracts. The mixed-effect logistic regression model results demonstrated that residents who (1) preferred primary health service institutions, (2) had a better knowledge of FDCS, (3) were more willing to visit primary health service after signing the contract with FDs, (4) were not intending to change FDs, (5) were satisfied with FDCS, and (6) trusted in FDs reported a higher level of willingness to maintain contracts with FDs. Our meta-analysis confirmed that older age, being married, having chronic diseases, choosing primary medical institutions for the first contact, having a good knowledge of FDCS/FDs, being satisfied with FDCS and the medical skills of FDs, and trusting FDs were all positively associated with residents' willingness to renew contracts (p < 0.05). The willingness of consumers to maintain contracts with FDs in China varies in different areas. Giving priority services to groups of high need contributed to an improved rate of renewal. We suggest that in order to continue to increase annual contract renewal, it is necessary to strengthen consumer awareness through effective marketing and continue to work toward meeting consumer expectations, thereby increasing confidence and trust in FDCS.