Zhongguo quanke yixue (Feb 2023)
Content Analysis and Optimization Path Exploration of Family Doctors' Contracting Service Agreements
Abstract
Background With the continuous progress of the New Medical Reform, contracting service by family physicians has increasingly become an important guarantee for the basic medical care and health of the people, and the agreements of family doctors' contracting service has become the premise of achieving "everyone has a family doctor". However, the standardization and binding force of the agreement still remain to be studied. Objective By analyzing the agreements of family doctors' contracting services, we expected to further standardize the contracting services and improve the standardized management level of the services contracted by family doctors. Methods According to the purpose of the survey, the contracting agreements of the 14 community health service centers were finally selected as subjects by random sampling among 1-3 community health service centers in each of the nine main districts of Chongqing in July 2021. The main analysis framework was based on the contracting subject, contracted service, contracting fee mechanism, and the rights and obligations of the contracting subject. Finally, descriptive analysis of the agreements was performed by means of content analysis. Results When compared the agreements in different districts, the contents of basic medical services and basic public health services were relatively similar (basic medical services included diagnosis and treatment services for common diseases, frequently occurring diseases and traditional Chinese medicine, etc., and basic public health services included establishing resident health files, providing health consultation, and vaccination, etc.) . There were differences in the terms of years of service, personalized services, etc. among family doctors in different regions of Chongqing: there were 12 agreements that specified a binding period of 1 year, 1 agreement whose duration was decided by the parties, and 1 agreement that did not specify the binding period. Among all agreements, the definition of the rights and obligations of contracting subjects and parties was vague. Among them, contracting subjects of 6 agreements included community health service centers, superior guidance hospitals, family doctors and representatives of heads of households or family representatives, 6 agreements included community health service centers, family doctors and representatives of heads of households or family representatives, 1 agreement included community health service centers and household heads, and 1 agreement did not specify the contracting subject. Conclusion It is necessary to further clarify the objects and agreements of contracting service, and improve the rights and obligations of the contracting subjects in Chongqing. Combined the experience of implementation of contracting services by family doctors of various regions, it is necessary to improve the performance effectiveness and the quality of the contracted services, and promote the implementation and development of the family doctors' contracting services.
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