Status And Effect Of Contracted Family Doctor Service For Community Residents In Guilin City

Objective: Since the implementation of family doctor contract service,it has shared the great pressure of Chinese medical system and provided practical medical convenience for Chinese residents.In this paper,based on the service quality gap model,through empirical research to understand the implementation of contracted services and the cognition of contracted services of family doctors in Guilin City,explore whether there is a gap between the expectation and perception of service quality,analyze the factors affecting service quality,find out the key problems,analyze the problems in the current service quality,and put forward reasonable suggestions.Promote the quality of contracted services of family doctors.Methods : The modified SERVQUAL scale was used as the survey tool to investigate the basic situation of residents in various communities in Guilin city and their cognition and understanding of contracted services of family doctors.Using single factor variance analysis,correlation analysis and multiple linear regression analysis to find out the factors affecting service quality.By issuing questionnaires,community residents in Guilin rated the expectation and actual perception of the contracted service quality of family doctors,sorted the scores of different service items,and found out the service items with high expected service quality and low felt service quality.The perception and expectation evaluation of different dimensions were compared,and SERVQUAL model scale was used to find out the items with large service quality gap.The IPA analysis method is used to bring the service items into the quadrant,find out the advantages,waste items,items to be improved and key improvement items of the service quality perception,and put forward countermeasures and suggestions for the service quality gap,so as to promote the high-quality development of the contracted services of family doctors.Results: A total of 481 valid questionnaires were collected through the questionnaire survey.According to the service quality gap formula Q=F-E,if Q > 0,there are 3 items without service quality problems,accounting for 13.6%;if Q < 0,there are 19 items with service quality problems,accounting for 86.4%.The perceived mean of the overall quality of service was 4.46 points,the expected mean of the overall quality of service was 3.85 points,and the difference was-0.61 points,indicating a gap in the overall quality of service.Among the gaps between expected value and perceived value of each dimension,continuity has the largest gap(0.91),followed by reliability(0.79).In the analysis of influencing factors,through regression analysis,it is concluded that the monthly income level of community residents,chronic diseases,understanding of the contract policy and the distance from home to the contract institution have an impact on the service quality of family doctors.In the service quality evaluation,the IPA analysis method found that there were 2 service quality evaluation indexes in the first quadrant advantage area,accounting for9.2%.The evaluation index of service quality in this quadrant is better.There were 3 service quality evaluation indexes in the second quadrant waste area,accounting for 13.6%.In the third quadrant,there is only one evaluation index of service quality in the area to be improved,accounting for 4.5%.In the fourth quadrant,there were 16 evaluation indexes of service quality in the key improvement area,accounting for 72.7%.Conclusions: The survey found that the overall effect of contract service quality of family doctors is not ideal,and the experience of service quality is not good.The monthly income level of community residents,chronic diseases,understanding of the signing policy and distance from home to the signing institution are the factors that influence the quality of family doctor’s signing service.In the evaluation of service quality gap,the service gap of continuity dimension is the largest.In the fourth quadrant of IPA analysis,16 evaluation indexes of service quality in the key improvement area had high expectations and poor actual experience.On the contrary,in the dominant area of the first quadrant,the service items that residents attach the most importance to have good service experience in two aspects: the effect after receiving treatment and the feeling of safety and rest during the service process,which are worthy of affirmation of family doctor service.In order to improve the service quality of family doctors,the reasons are analyzed from different angles,and reasonable suggestions are given: strengthen the publicity of chronic disease prevention and control,increase the variety of drugs;Strengthen follow-up and health examination after treatment to ensure the continuity of service quality;Strengthen humanistic care,provide personalized contract service package,enhance patients’ medical experience;Standardizing the diagnosis and treatment procedures for medical personnel and strengthening standardized training for general practitioners;Measures to speed up the construction of family doctors and improve the quality of family doctor services.