Prevalence of Met Needs for Contracted Family Doctor Services and Associated Factors in Young and Middle-aged Office Building Occupants

Abstract

Background Shanghai is gradually expanding the supply of family doctor contract service to building functional communities, but the prevalence of met needs of such services in young and middle-aged office building occupants is still unknown, and relevant studies on the prevalence and associated factors could inform the development and improvement of policies regarding building-based family doctor services. Objective To explore the prevalence of met needs for contracted family doctor services and associated factors in young and middle-aged office building occupants. Methods A questionnaire survey was implemented from December 2019 to December 2020 in the setting of office buildings selected by typical sampling from Hongkou District, Pudong New District and Jing'an District of Shanghai. Among the young and middle-aged occupants (n=2 272, 18-59 years old) selected from the buildings by use of cluster random sampling to attend the survey, 1 137 with an experience of using contracted family doctor services were determined as the participants. The survey involved four aspects, including sociodemographic and economic characteristics, health status, understanding level of contracted family doctor services, and met needs of these services (containing essential and personalized service needs assessed using a 5-point Likert scale). Multinomial and ordinal Logistic regression was used to analyze factors associated with met needs of contracted family doctor services. Results The prevalence of having needs of essential family doctor services considerably/completely met was 39.61% (425/1 073). And that of having needs of personalized family doctor services considerably/completely met was 39.01% (419/1 074). Multinomial and ordinal Logistic regression analysis revealed that registered place of household (Shanghai or not), occupation, annual income, self-rated health, understanding of the "1+1+1" type of contracted family doctor services, level of trust in family doctors, and evaluation of family doctors' service capabilities were associated with met needs of essential family doctor services (P<0.05). Sex, annual income, chronic disease prevalence, understanding of the "1+1+1" type of contracted family doctor services and the composition of a family doctor team, as well as evaluation of family doctors' service capabilities were associated with met needs of personalized family doctor services (P<0.05) . Conclusion The prevalence of self-reported met needs of essential or personalized family doctor services in the young and middle-aged office building occupants was about 40%, which was associated with sociodemographic and economic characteristics, health status, understanding level of contracted family doctor services, and self-assessed family doctors' service capabilities. It is recommended to improve the publicity of the system of contracting family doctor services, customize personalized service plans according to the characteristics and differentiated needs of the population, improve the family doctor's service capabilities and enrich the services.

Keywords

• contracted family doctor services|young and middle-aged office building occupants|health services needs and demand|root cause analysis|shanghai