Effectiveness Evaluation of Contracted Residents' First Contact in Primary Care in the Context of Contracted Family Doctor Services

Abstract

Background Since the comprehensive implementation of the contracted family doctor service in 2016, the willingness of residents to have their first contact in primary care has gradually increased, but the effectiveness evaluation of contracted residents' first contact in primary care needs to be further explored. Objective To understand the current status of contracted residents' first contact evaluation, explore its influencing factors and propose improvement strategies. Methods A multi-stage stratified random sampling method was used to select 54 community health service institutions/township health centers in three cities in Shandong Province, with a total of 4 000 contracted residents. The first contact dimension questionnaire of the Chinese version of the Primary Care Quality Assessment Scale (PCAT) was used to conduct the survey, comparing the first contact dimension scores of contracted residents with different characteristics and using multiple linear regression to analyse the factors affecting the first contact evaluation of contracted residents. Results A total of 3 859 valid questionnaires were collected, with the effective recovery rate of 96.48%. Among them, 2 086 (54.1%) were residents of township health centers and 1 773 (45.9%) were residents of community health centers; the total score of the first contact dimension in the three regions was 3.49, with the highest score being "Is your contracted institution open on Saturdays and Sundays?" (3.74) ; the item with the lowest score was "During non-business hours, if you were sick at night, would your contracted facility have a doctor or nurse available?" (3.05). The results of the multiple linear regression analysis showed that the contracted facility, personal monthly income, education level, marital status, occupation, physical health and diagnosis of chronic disease were the factors influencing the scores of the first contact dimension of contracted residents (P<0.05) . Conclusion The first contact evaluation result of contracted residents is good, but there is still a need to strengthen the promotion of family doctor contracting service policy, guide contracted residents to form the concept of primary care, and promote primary care by clarifying the process of non-working day consultations, improving the service supply capacity of primary care institutions, strengthening the construction of the sharing platform of medical institutions, and leveraging the medical insurance system, so as to improve the first contact evaluation of contracted residents.

Keywords

• community health services|contracted family doctor services|first contact|primary care assessment tools|primary medical institutions|shandong province