The impact of family doctor system on patients' utilisation of general practitioner in primary care facilities—Evidence from Hangzhou, China

Abstract

Objective This study aims to examine whether participating in the contracted family doctor system increases patients' utilisation of primary care general practitioner for multiple disease outcomes in China. Methods Binary logistic regression models were estimated using data collected from 372 community residents in nine selected districts of Hangzhou, China. Results Findings revealed that (1) for patients with influenza, diabetes, upper respiratory infection, and gingivitis, those who participated in the contracted family doctor system were approximately 4.3 times, 98.4%, 92.5%, and 52.8% more likely to choose primary care general practitioners (GP) for their initial diagnosis, respectively, as compared with their counterparts who did not have contracted family doctors; (2) For patients with stroke or cerebrovascular disease and cholecystitis or cholelithiasis, those who had contracted family doctors were 1.111 times and 80.6% more likely to choose primary care GP for their subsequent disease maintenance, respectively, as compared to their counterparts without contracted family doctors. Conclusion Our findings indicate that the contracted family doctor system not only increases the utilisation of primary care GP for patients with many chronic conditions but also promotes the overall completion of China's hierarchical medical system in the long run. Policy implications were provided to help policymakers actively construct and develop the contracted family doctor system to promote the hierarchical medical system in China.

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

“…Compared with urban areas, rural areas had scarcer medical resources [ 26 , 43 ] , and hypertension follow-up services were also basically provided by village doctors who serve as family doctors [ 44 ]. Family doctor services can exactly provide the basic medical services and the health management services for rural older adults with chronic diseases [ 4 , 45 ]. Traditional interpersonal communication style and the mutual trust made family doctors’ home visits more acceptable in rural areas [ 46 ].…”

“…Family doctor contract services refer to the model of proactive, continuous and comprehensive health accountability management provided by family doctors signing service contracts with residents [ 1 ], which has become the basis of the hierarchical medical system in China [ 2 ]. In addition to providing basic medical and public health services to contracted residents, family doctors also provide long-term follow-up and case-based management for patients with chronic diseases such as hypertension and diabetes [ 3 ].…”

Exploring Residents’ Healthcare Utilization under the Family Physician Contract Service System in China: Implications for Primary Healthcare

“…Moreover, continuity of care was an important factor in fostering the patient-physician relationship [50]. Te contracted family physician system not only increased the utilization of primary care for patients with chronic disease but also promoted the overall completion of China's tiered healthcare system in the long run [36,51]. Family physician contract service allows for a long term and stable relationship between family physicians and residents or patients, so as to enhance individuals' trust in the quality of primary care.…”

Strategies for General Practitioners to Enhance Cancer Care: Insights from a Patient-Centered Questionnaire Survey in Southern China

“…In recent years, community hospitals have improved their ability to manage chronic diseases such as hypertension, diabetes, stroke, chronic obstructive pulmonary disease and other common diseases. 20 However, the management of cancer in the form of chronic diseases in China is still in its infancy, without an accepted and effective care model. Even in Guangzhou, a first-tier city in China, cancer has not yet been included in the standard community chronic disease management.…”