Do older people with cardiovascular-metabolic multimorbidity prefer to sign contracts for family doctor services? Evidence from a cross-sectional study in rural Shandong, China

Yang, Shijun; Li, Jie; Fu, Peipei; Chen, Yan; Wang, Yi; Zhao, Dan; Li, Zhixian; Li, Wenjuan; Gui, Zhen; Zhou, Chengchao

doi:10.1186/s12877-021-02543-w

Cited by 8 publications

(10 citation statements)

References 25 publications

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“…The signing rate of FDCS in the current study was 54.3%, which was similar to the findings in Guangdong (54.7%) and Zhejiang province (50.43%) [ 14 , 15 ], but much higher than that from a nationwide survey in mainland China (approximately 6.0% in the female population) [ 16 ]. Researchers also found lower signing rates among people over 60 years old (28.2%) and with chronic diseases (29.3%) in rural China [ 17 , 18 ]. Here, the socioeconomic and regional differences may provide a potential explanation for these inconsistencies to some extent.…”

Section: Discussionmentioning

confidence: 99%

Associations between the signing status of family doctor contract services and cervical cancer screening behaviors: a cross-sectional study in Shenzhen, China

et al. 2023

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Background As a core part of the primary healthcare system, family doctor contract services (FDCS) may help healthcare providers promote cervical cancer screening to the female population. However, evidence from population-based studies remains scant. This study aimed to investigate the potential associations between the signing status of FDCS and cervical cancer screening practices in Shenzhen, China. Methods A cross-sectional survey among female residents was conducted between July to December 2020 in Shenzhen, China. A multistage sampling method was applied to recruit women seeking health services in community health service centers. Binary logistic regression models were established to assess the associations between the signing status of FDCS and cervical cancer screening behaviors. Results Overall, 4389 women were recruited (mean age: 34.28, standard deviation: 7.61). More than half (54.3%) of the participants had signed up with family doctors. Women who had signed up for FDCS performed better in HPV-related knowledge (high-level rate: 49.0% vs. 35.6%, P<0.001), past screening participation (48.4% vs. 38.8%, P<0.001), and future screening willingness (95.9% vs. 90.8%, P<0.001) than non-signing women. Signing up with family doctors was marginally associated with past screening participation (OR: 1.13, 95%CI: 0.99–1.28), which tended to be robust among women with health insurance, being older than 25 years old at sexual debut, using condom consistently during sexual intercourse, and with a low level of HPV related knowledge. Similarly, signing up with family doctors was positively associated with future screening willingness (OR: 1.68, 95%CI: 1.29–2.20), which was more pronounced among women who got married and had health insurance. Conclusions This study suggests that signing up with family doctors has positive associations with cervical cancer screening behaviors among Chinese women. Expanding public awareness of cervical cancer prevention and FDCS may be a feasible way to achieve the goal of cervical cancer screening coverage.

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Section: Discussionmentioning

confidence: 99%

Associations between the signing status of family doctor contract services and cervical cancer screening behaviors: a cross-sectional study in Shenzhen, China

et al. 2023

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“…Shandong Province is the second most populous province in China, with a population of 101.70 million people in 2021, of which 36.06% population lived in rural areas [ 23 , 72 ]. Shandong Province is also an economically developed region in eastern China, with a GDP of 1147.13 billion US dollars in 2021 [ 72 ].…”

Section: Methodsmentioning

confidence: 99%

“…Family doctors with turnover intention result in lower morale, hidden absenteeism, and poor performance [ 22 ]. The prevalence of chronic diseases is higher and the accessibility of medical resources is lower in rural China [ 13 , 23 ]. Widespread and continuous turnover intention of rural family doctors could aggravate the shortage of human resources, undermine the stability and sustainability of the healthcare system, and reduce the quality of primary health care, all of which are detrimental to improving the health status of rural residents.…”

Section: Introductionmentioning

confidence: 99%

How surface acting affects turnover intention among family doctors in rural China: the mediating role of emotional exhaustion and the moderating role of occupational commitment

et al. 2023

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Background Family doctors in rural China are the main force for primary health care, but the workforce has not been well stabilized in recent years. Surface acting is an emotional labor strategy with a disparity between inner feelings and emotional displays, provoking negative effects such as emotional exhaustion, occupational commitment reduction, and, consequently, increasing turnover rate. With the Conservation of Resources theory, this study explores how the surface acting of rural family doctors affects turnover intention through emotional exhaustion and investigates what role occupational commitment plays in this relationship. Methods With a valid response rate of 93.89%, 953 valid data were collected by an anonymous self-administered questionnaire survey in December 2021 in Shandong Province, China. Cronbach’s Alpha and confirmatory factor analysis (CFA) were used to estimate reliability and construct validity, respectively. The PROCESS macro in SPSS was performed to analyze the mediating and moderated mediation effects of surface acting, emotional exhaustion, occupational commitment, and turnover intention. Results Reliability and validity indicated that the measurement instruments were acceptable. Surface acting had a direct positive effect on turnover intention (β = 0.481, 95% CI [0.420, 0.543]). Emotional exhaustion partially mediated the effect of surface acting on turnover intention (indirect effect: 0.214, 95% CI [0.175, 0.256]). Occupational commitment moderated the effect of emotional exhaustion on turnover intention (β = − 0.065, 95% CI [− 0.111, − 0.019]), and moderated the indirect effect of surface acting on turnover intention via emotional exhaustion (index of moderated mediation: − 0.035). Conclusions Emotional exhaustion partially mediates the relationship between surface acting and turnover intention among family doctors in rural China, and occupational commitment moderates the direct effect of emotional exhaustion on turnover intention and further moderates the mediating effect. Policymakers should pay more attention to the effects of emotional labor and emotional resource depletion on the stability of rural health human resources.

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“…The role of family doctors in improving the health status of the residents is gradually being proven [ 4 , 5 ]. As the key population of family doctor contract services, older adults with chronic conditions have a higher need for health management [ 6 ], and they are more likely to contract with family doctors [ 7 , 8 ]. It is now well established from a variety of studies, that a higher contracting rate is associated with better chronic disease self-management and lower health care costs [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of hypertension follow-up management on the choices of signing up family doctor contract services: does socioeconomic status matter?

Wang,

Chu,

Zhao

et al. 2024

BMC Prim. Care

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Background This study aimed to explore the association between hypertension follow-up management and family doctor contract services, as well as to examine whether socioeconomic status (SES) had an interaction effect on this relationship among older adults in China. Methods We used data from the sixth National Health Service Survey of Shandong Province, China, including 3,112 older adults (age ≥ 60 years) with hypertension in 2018. Logistic regression models and a margins plot were used to analyze the role of SES in the relationship between hypertension follow-up management and family doctor contract services. Results The regular hypertension follow-up management rate and family doctor contracting rate were 81.8% and 70.9%, respectively, among older adults with hypertension. We found that participants with regular hypertension follow-up management were more likely to sign family doctor contract services (OR=1.28, 95%CI: 1.04, 1.58, P=0.018). The interaction effect occurred in the groups who lived in rural areas (OR=1.55, 95%CI: 1.02, 2.35), with high education level (OR=0.53, 95%CI: 0.32, 0.88) and had high incomes (OR=0.53, 95%CI: 0.35, 0.81). Conclusions Our findings suggested that regular hypertension follow-up management was associated with family doctor contract services and SES influenced this relationship. Primary health care should improve the contracting rate of family doctors by strengthening follow-up management of chronic diseases. Family doctors should focus on improving services quality and enriching the content of service packages especially for older adults with higher income and education level.

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Do older people with cardiovascular-metabolic multimorbidity prefer to sign contracts for family doctor services? Evidence from a cross-sectional study in rural Shandong, China

Cited by 8 publications

References 25 publications

Associations between the signing status of family doctor contract services and cervical cancer screening behaviors: a cross-sectional study in Shenzhen, China

Associations between the signing status of family doctor contract services and cervical cancer screening behaviors: a cross-sectional study in Shenzhen, China

How surface acting affects turnover intention among family doctors in rural China: the mediating role of emotional exhaustion and the moderating role of occupational commitment

The impact of hypertension follow-up management on the choices of signing up family doctor contract services: does socioeconomic status matter?

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