Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies
BackgroundA number of studies have investigated the influencing factors regarding the renewal of contracts associated with Family Doctor Contract Services (FDCS) in different regions of China since it was officially implemented in 2009; however, none of the previous studies have been considered usin...
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1162824/full |
| _version_ | 1797383008387334144 |
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| author | Xinyan Li Jun Ye Jing Feng Qiaosen Chen Ge Qu Zhengyi Wan Zihui Lei Adamm Ferrier Heng Jiang Heng Jiang Yanling Zheng Yong Gan |
| author_facet | Xinyan Li Jun Ye Jing Feng Qiaosen Chen Ge Qu Zhengyi Wan Zihui Lei Adamm Ferrier Heng Jiang Heng Jiang Yanling Zheng Yong Gan |
| author_sort | Xinyan Li |
| collection | DOAJ |
| description | BackgroundA number of studies have investigated the influencing factors regarding the renewal of contracts associated with Family Doctor Contract Services (FDCS) in different regions of China since it was officially implemented in 2009; however, none of the previous studies have been considered using a nationally representative sample in combination with a meta-analysis.MethodsA multistage stratified sampling method was used to investigate participants’ socio-demographic characteristics, health status, understanding, use, and evaluation of the FDCS, and their willingness to renew contracts in Eastern, Central, and Western China from September to November 2021. We searched the PubMed, Ovid Medline, CNKI, VIP, Wanfang, and SinoMed databases to retrieve previous studies related to the willingness of Chinese residents to renew contracts with their family doctor (FD), and a meta-analysis was performed to systematically summarize the willingness to maintain contracts and influencing factors.ResultsAmong 2,394 residents, 2,122 (88.64%) were willing to renew their contracts. The mixed-effect logistic regression model results demonstrated that residents who (1) preferred primary health service institutions, (2) had a better knowledge of FDCS, (3) were more willing to visit primary health service after signing the contract with FDs, (4) were not intending to change FDs, (5) were satisfied with FDCS, and (6) trusted in FDs reported a higher level of willingness to maintain contracts with FDs. Our meta-analysis confirmed that older age, being married, having chronic diseases, choosing primary medical institutions for the first contact, having a good knowledge of FDCS/FDs, being satisfied with FDCS and the medical skills of FDs, and trusting FDs were all positively associated with residents’ willingness to renew contracts (p < 0.05).ConclusionThe willingness of consumers to maintain contracts with FDs in China varies in different areas. Giving priority services to groups of high need contributed to an improved rate of renewal. We suggest that in order to continue to increase annual contract renewal, it is necessary to strengthen consumer awareness through effective marketing and continue to work toward meeting consumer expectations, thereby increasing confidence and trust in FDCS. |
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| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-08T21:14:33Z |
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| spelling | doaj.art-a769e131a1e447d798734c5b910cc0292023-12-22T04:14:25ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-12-011110.3389/fpubh.2023.11628241162824Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studiesXinyan Li0Jun Ye1Jing Feng2Qiaosen Chen3Ge Qu4Zhengyi Wan5Zihui Lei6Adamm Ferrier7Heng Jiang8Heng Jiang9Yanling Zheng10Yong Gan11Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Public Management, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDivision of Cardiovascular Medicine, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, SwedenDepartment of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, AustraliaDepartment of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, AustraliaMelbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, AustraliaDepartment of General Practice, Shouyilu Street Community Health Service Center, Wuhan, Hubei, ChinaDepartment of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaBackgroundA number of studies have investigated the influencing factors regarding the renewal of contracts associated with Family Doctor Contract Services (FDCS) in different regions of China since it was officially implemented in 2009; however, none of the previous studies have been considered using a nationally representative sample in combination with a meta-analysis.MethodsA multistage stratified sampling method was used to investigate participants’ socio-demographic characteristics, health status, understanding, use, and evaluation of the FDCS, and their willingness to renew contracts in Eastern, Central, and Western China from September to November 2021. We searched the PubMed, Ovid Medline, CNKI, VIP, Wanfang, and SinoMed databases to retrieve previous studies related to the willingness of Chinese residents to renew contracts with their family doctor (FD), and a meta-analysis was performed to systematically summarize the willingness to maintain contracts and influencing factors.ResultsAmong 2,394 residents, 2,122 (88.64%) were willing to renew their contracts. The mixed-effect logistic regression model results demonstrated that residents who (1) preferred primary health service institutions, (2) had a better knowledge of FDCS, (3) were more willing to visit primary health service after signing the contract with FDs, (4) were not intending to change FDs, (5) were satisfied with FDCS, and (6) trusted in FDs reported a higher level of willingness to maintain contracts with FDs. Our meta-analysis confirmed that older age, being married, having chronic diseases, choosing primary medical institutions for the first contact, having a good knowledge of FDCS/FDs, being satisfied with FDCS and the medical skills of FDs, and trusting FDs were all positively associated with residents’ willingness to renew contracts (p < 0.05).ConclusionThe willingness of consumers to maintain contracts with FDs in China varies in different areas. Giving priority services to groups of high need contributed to an improved rate of renewal. We suggest that in order to continue to increase annual contract renewal, it is necessary to strengthen consumer awareness through effective marketing and continue to work toward meeting consumer expectations, thereby increasing confidence and trust in FDCS.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1162824/fullfamily doctorcontract servicesrenewal willingnessmeta-analysiscross-sectional studies |
| spellingShingle | Xinyan Li Jun Ye Jing Feng Qiaosen Chen Ge Qu Zhengyi Wan Zihui Lei Adamm Ferrier Heng Jiang Heng Jiang Yanling Zheng Yong Gan Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies Frontiers in Public Health family doctor contract services renewal willingness meta-analysis cross-sectional studies |
| title | Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies |
| title_full | Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies |
| title_fullStr | Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies |
| title_full_unstemmed | Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies |
| title_short | Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies |
| title_sort | willingness to maintain contracts with family doctors among chinese residents results from one national cross sectional study and a meta analysis of 25 studies |
| topic | family doctor contract services renewal willingness meta-analysis cross-sectional studies |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1162824/full |
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