The association of family doctor contract service and patient trust in doctor: evidence from twenty-five village clinics of three counties in rural China

Abstract

Background China is implementing the family doctor (FD) system to reform the primary healthcare (PHC). The family doctor contract service (FDCS) policy plays a crucial role in this system implementation, aiming to transform the doctor-patient relationship and enhance PHC quality. This study aims to investigate the impact of FDCS on the doctor-patient relationship in PHCs using field research methodology. Method The field research methodology was employed to address the research questions. Quantitative methods were utilized for data collection and analysis. A structure questionnaire was used to collect data based on the research questions. Our investigation encompassed twenty-five village clinics across three counties in China. A total of 574 subjects helped us to finish this investigation in the study. The collected data was analyzed using statistical analysis including ordinary least squares (OLS) model and propensity scores matching model (PSM) to estimate the relationship. Result The findings from ordinary least squares (OLS) regression revealed that FDCS had a positive influence on patient trust in doctors within PHCs, with patients who participated the FDCS exhibiting higher levels of trust compared to those who did not participate. Propensity score matching (PSM) analysis further confirmed these results by accounting for selection bias. Conclusions The implementation of family doctor contract service has brought about significant transformation in the doctor-patient relationship within rural Chinese PHCs. In essence, it has revolutionized the service model of doctor in PHC, playing a pivotal role in improving primary health quality and enhance the service capability of doctors in PHC. This transformative process has been crucial for carrying out hierarchical diagnosis and treatment policy, which aims to adjust the medical service structure and optimizing the health service system. Therefore, it is imperative for government authorities and health administration departments to ensure continuous support for this essential service through appropriate formulation.

Has China’s hierarchical medical system improved doctor-patient relationships?

“…Li et al [ 18 ] conducted a cross-sectional survey of 16 patients with chronic diseases in 847 primary care organizations in Jilin Province and found that contractual services could directly or indirectly influence patients’ perceived engagement, which in turn influenced the relationship between doctors and patients. Gu et al [ 38 ], based on questionnaire data from 574 rural clinics in three counties in China, reported that the implementation of family physician contract services played a key role in changing doctor-patient relationships and helped to attract more patients to primary care centers.…”