Zhongguo quanke yixue (Dec 2022)
Family Doctor Confidence Index among General Practitioners in Shanghai's Pudong New Area: Trend Analysis during 2014—2020 Using Survey Data
Abstract
Background Family doctors play a major role in the construction of the family doctor system, one of the five basic projects in Shanghai launched since April 2011, so understanding their confidence level regarding practice is crucial to the promotion of high-quality development of family doctor system in China. Objective To investigate the family doctor confidence index (FDCI) in 2020 and its trend from 2014 to 2020 among general practitioners (GPs) in Pudong New Area of Shanghai, and to predict their future 3-year FDCI, providing insights into the promotion of the construction of family doctor system. Methods Participants were incumbent GPs who provided family care services in 9 community health centers in Pudong New Area of Shanghai, the settings in which the 2014 FDCI survey in Shanghai's Pudong New Area was conducted. They were invited to attend an online survey through the platform of www.wjx.cn in December 2020 using a questionnaire developed by ourselves based on the implementation of family doctor system in Pudong New Area, the contents of E2-E3 pages of the original China Medical Tribune·General Practice Weekly published on June 22, 2017, and the survey contents of FDCI developed by GU Yuan Family Doctor Studio. FDCI was compared by demographic indices. The future 3-year FDCI was estimated overall, and compared across GPs by demographic indices. The trend of FDCI between 2014 and 2020 was analyzed. Results A total of 350 cases attended the survey, and 347 of them (99.1%) who returned were responsive questionnaires were included for analysis. The average FDCI of the participants was (51.96±28.42) in 2020, and that predicted for 2023 was (54.03±26.56) , showing no significant difference (P>0.05) . In 2020, GPs working at rural areas had higher FDCI than those working at urban and peri-urban areas (P<0.05) ; Those who became a GP after training prior to the post shift had higher FDCI than those who became a GP after standardized residency training or passing the professional title examination (P<0.05) ; GPs with junior college education or below had higher FDCI than those with a bachelor/master degree or above (P<0.05) ; GPs who held a concurrent administrative post or handled administrative matters in their hospital had higher FDCI than those did not (P<0.05) . Higher FDCI predicted for 2023 was found in those with working at rural areas instead of those working at urban and peri-urban areas, and in those with junior college education or below instead of those with a bachelor /master degree or above (P<0.05) . Those who were male, aged 23-29, worked at urban area, had an experience of≤1 or>5 years of working as a family doctor, had a bachelor degree or intermediate professional title were predicted to have higher FDCI in 2023 than in 2020 (P<0.05) . The overall FDCI in 2020 was higher than that in 2014〔 (51.96±28.42) vs (24.65±22.75) 〕and 2017〔 (51.96±28.42) vs (48.20±23.10) 〕, with statistical significance (P<0.05) . Conclusion The overall FDCI of GPs in Shanghai's Pudong New Area in 2020 and that predicted for 2023 was moderate, and the overall FDCI in 2020 was significantly higher than that in 2014 and 2017. The present and future 3-year FDCI varied among GPs by demographic characteristics. GPs were fully confident in the future development of the industry and their own occupation, and needed continuous policy and social supports.
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