Evaluation Study On Contracted Service Of Family Physicians In Kaili City

Background and objective:The family doctor contract service takes the family doctor as the first person in charge and provides medical and health services to the residents through the team-assisted contract relationship.The evaluation of the contracted service of family doctors by the contracted residents is helpful to improve the quality of contracted service of family doctors.From the perspective of demand side,this paper investigates the evaluation of community contracted family doctors’ contract service,analyzes the relationship between each evaluation index and the total score of family doctor’s contract service evaluation,and discusses the strategies to improve the quality of family doctor’s contract service.In order to provide a scientific basis for the formulation of policies related to the contract service of family doctors.Methods:Anderson’s theoretical model,health belief and public goods theory were applied in three community health service centers in Kaili City,Miao and Dong Autonomous Prefecture,Southeast Guizhou from August to September 2019.A self-administered questionnaire survey was conducted on 162 contracted residents.The main indicators of the questionnaire are divided into six dimensions:publicity factors,work flow,physician factors,institutional factors,general services and special services,with a total of 17 indicators.The score was evaluated by Likert(Likert Scale)attitude scale 5-grade scoring method.Statistical analysis methods include t-test,one-way ANOVA,linear correlation analysis and multiple linear regression analysis.The reliability and validity of the questionnaire were measured.The Cronbach’s alpha value was 0.909 and the KMO value was 0.868.The results are as follows:1.The scores of institutional factors(3.19±0.920),general service(3.19 ±0.786)and special service(2.90 ±0.820)were lower than the total score of contract service evaluation(3.24±0.918).2.The total score of contract service evaluation of family doctors was(3.24±0.918),and the scor es of institutional factors,general service and special service in each dimension were lower than those of contract service evaluation(3.24±0.918);2.There wer e significant differences in the evaluation of contract service among different a ges,marital status,nationality,individual monthly income,service cognition,disea se management and disease perception(P<0.05);3.There were six dimensions of correlation between the total score of contract service evaluation and the follo wing six dimensions: propaganda(R=0.771,P=0.000),workflow(R=0.775,P=0.000),physician(R=0.817,P=0.000),institution(R=0.739,P=0.000),general service(R=0.806,P=0.000),special service(R=0.787,P=0.000).4.Multiple linear regression showed t-hat after controlling the social demographic characteristics,the total score of co-ntract service evaluation of family doctors could be predicted by 7 indexes,suc-h as signing process,visiting process,doctor’s diagnosis and treatment level,community service charge,health education,common disease diagnosis and treatme-nt care,and expanding special needs paid service.The partial regression coefficients were 0.214,0.169,0.244,-0.102,0.199,0.104,0.207(P<0.05).Research conclusions:1.The contracted residents do not have a high evaluation of the family doctor signing service,which is more prominent in terms of institutional factors,general services and special services;2.The total score of contract service evaluation was positively correlated with propaganda factors,work flow,institutional factors and special services,and strongly positively correlated with general services and physician factors.among them,the total score of contract signing process,medical process,doctor’s diagnosis and treatment level,community service charge,health education,diagnosis and treatment of common diseases and expanded paid service for special needs can be predicted and evaluated by 7 indexes:contract process,medical process,doctor’s diagnosis and treatment level,community service charge,health education,diagnosis and treatment of common diseases,and expansion of paid service for special needs.Suggestion:1.To shorten the service work flow,we can rely on Internet and big data industry;2.Improve the diagnosis and treatment level of family doctors and optimize the configuration of the family doctor team;3.Reduce community health service charges and attract contracted residents;4.Attach importance to health education programs and provide diversified ways of education;5.Strengthen diagnosis,treatment and nursing,special need paid contract service,and give full play to the advantages of ethnic medicine.