The impact of public policy of family doctor contracting on medical expenses from the perspective of residents at community level in China

Abstract

ObjectiveTo analyze the impact of the contract of family doctors in community-level in Beijing on residents’ medical expenses, so as to explore the efficacy of family physician contract service to facilitate the hierarchical treatment system. This study pioneeringly used the panel data of medical records and medical insurance settlement details provided by a community hospital in Beijing. By analyzing the correlation between family doctors and medical expenses, the study provided empirical support for the advancement of family doctor contracting in China.MethodsUsing the panel data of medical records and medical insurance settlement details of 5,851 residents in a community hospital in Beijing from January 2018 to May 2021 for a total of 41 months, mixed-effects model and random-effects model were used for analysis.ResultsThe contract of family doctor has significantly increased residents’ medical expenses. The types of medical insurance and whether patients with chronic diseases have a significant impact on residents’ medical expenses.ConclusionFamily doctor contracting increases the probability of residents seeing a doctor in community hospitals. Community family doctor contracting services should be vigorously promoted, especially for special groups such as chronic disease patients and the elderly. The increase in the contracting rate of family doctors will become an important starting point for promoting hierarchical medical system and increasing the primary treatment at the community-level.

Health Management Service Models for the Elderly with Visual Impairment: A Scoping Review

“…The signing of a family doctor solidifies the contractual relationship between community residents and general practitioners through a contract, which can effectively improve the continuity of patient nursing. 81 Family doctors provide primary care services and community health education can reduce the disease burden by up to 70%. 82 The community health service agency factor is the factor that affects the effect of the family contract service model.…”

The association between family doctor contract services and the health of middle-aged and older people in China: an instrumental variables analysis

“…In addition, family doctors play the role of the agent to provide health care services to residents directly. Moreover, FDCS currently covers basic medical services, basic public health services, and personalized services 24 .…”

Understanding the Impact of Community Family Physician Contracting (CFPC) on Community Medical Resources Consumption: A Case Study from Beijing in China

“…Instead, they rely on data on medical costs to draw their conclusions. Te Anderson model, which has been utilized extensively in the study of health care use accessibility [8][9][10][11], is a traditional framework for assessing individual health service consumption behavior. Based on the monthly settlement data provided by community hospitals in Beijing, this study uses three dimensions of propensity characteristics, enabling resources, and medical need to visually analyze the impact of CFPC on the medical expenses of residents in the community hospitals in order to examine the role of CFPC in promoting hierarchical triage and optimizing the allocation of medical resources.…”