Factors Influencing Patients’ Contract Choice With General Practitioners in Shanghai

Jing, Limei; Shu, Zhiqun; Sun, Xiaoming; Chiu, John F.; Lou, Jiquan; Xie, Chunyan

doi:10.1177/1010539514561654

Cited by 30 publications

(51 citation statements)

References 8 publications

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“…As mentioned previously, the government and health administrative department of Zhejiang Province has also actively promoted the GP contract service in recent years, which has seen the contract signing rate in Zhejiang Province increase yearly. As mentioned earlier, the elderly have more opportunities to sign contracts with their GP [10,11]; therefore, under the background of limited medical resources, the elderly (especially those with chronic diseases) are always given priority to the GP contract service in China, including Zhejiang province.…”

Section: Discussionmentioning

confidence: 99%

“…The signing rate of the surveyed residents in 34 counties of China was 38.40% in 2014, with higher rates in residents with hypertension or diabetes (42.91% and 45.38%, respectively) [8]. The factors influencing residents’ contract behavior were various in different reports; however, advanced age was commonly proven to be related with higher signing rate [10,11]. In Zhejiang Province, the contract prioritizes vulnerable people, such as the elderly aged over 60 years.…”

Section: Introductionmentioning

confidence: 99%

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Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

Zhao

Lin

Qiu

et al. 2017

IJERPH

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This study aims to examine whether the urban elderly in the Zhejiang Province of China signed contracts with their general practitioner (GP) based on their health service needs, and to further identify the determinants of their demand and signing decisions. A community-based cross-sectional study was conducted in 16 community health service (CHS) institutions in Zhejiang Province, China. The urban elderly over 60 years of age were enrolled when visiting the sampled CHS. Baseline characteristics were compared between participants using Chi-Square tests for categorical variables. Univariate and multivariable logistic regression analyses were used to identify determinants of the GP contract service demand and signing decisions, respectively. Among the 1440 urban elderly, 56.67% had signed contracts with their GP, and 55.35% had a demand of the GP contract service. The influencing factors of demand were a history of diabetes or cardiovascular disease (OR = 1.33, 95% CI, 1.05–1.68); urban resident basic medical insurance (URBMI) vs. urban employee basic medical insurance (UEBMI) (OR = 1.96, 95% CI, 1.46–2.61); and middle-income vs. low-income (OR = 0.67, 95% CI, 0.50–0.90 for RMB 1001–3000; OR = 0.59, 95% CI, 0.39–0.90 for RMB 3001–5000). Having a demand for the GP contract service was the strongest determinant of signing decisions (OR = 13.20, 95% CI, 10.09–17.27). Other factors also contributed to these decisions, including gender, caregiver, and income. The urban elderly who had signed contracts with GPs were mainly based on their health care needs. Elderly people with a history of diabetes or cardiovascular disease, as well as those with URBMI, were found to have stronger needs of a GP contract service. It is believed that the high-income elderly should be given equal priority to those of low-income.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

Zhao

Lin

Qiu

et al. 2017

IJERPH

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“…At the same time, if patients signed a patient‐GP contract with their GPs in the primary care system in Shanghai, the same messages would also be sent to their GP. The patient‐GP contract is a critical part in the GP system in Shanghai …”

Section: Resultsmentioning

confidence: 99%

“…The ultimate goal of the GP system is that each family can have its own GP, and the patient‐GP contract is the first critical step for GPs to establish stable contact with residents. In patient‐GP contract, two sides' rights and obligations are clearly defined …”

Section: Discussionmentioning

confidence: 99%

An evaluation of the effects of general practitioner–supported patient noncommunicable diseases control model in Shanghai, China

Shu

Ling

Sun

2019

Health Planning & Management

Self Cite

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Summary Noncommunicable diseases (NCDs) are the leading cause of death worldwide. A litmus test for China's health reform is its ability to effectively deal with NCDs. The general practitioners (GPs)–supported NCD control model was designed to address ways to effectively prevent and control NCDs population‐wide. This study aimed to evaluate the GPs‐supported NCD control model and its effect on China's NCD control. The model was structured with three layers of two‐way relationships between patients, GPs, and specialists. The four technologies included the community‐based NCD self‐management model, the electronic clinical‐pathways–supporting community NCD intervention, the largest regional independent medical information system engaged by the Shanghai Healthcare Cloud, and continuous and successive policy intervention. Under the influence of the model, hypertension awareness, treatment, and control were the highest in Shanghai. By 31 August 2017, 131 453 users declined to use the mobile application while 10 444 completed the type 2 diabetes mellitus (T2DM) risk assessment. By 15 August 2017, 249 000 residents had participated in early detection and screening, leading to the identification of 29 304 (11.8%) being in a prediabetic state and 24 422 (9.8%) being newly diagnosed with T2DM. From 2012 to 2016, 208 537 patients were newly identified with hypertension using Internet‐connected devices and hypertension awareness increased 5.7%. After implementing the self‐management interventions, patients' blood pressure was controlled at around 90% (from 2007 to 2015). This pilot model in Shanghai suggested positive social benefits and appears to have played an important role in advancing NCD control in China.

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“…Over the world, more than 50 countries have health care systems based on the GP model [18]. Some of those countries such as UK, Germany and USA have developed advanced GP management system which integrates capacity evaluation with pre-occupation schooling and post-occupation training, performance appraisal and incentive mechanism throughout a GP’s entire career [19–23].…”

Section: Introductionmentioning

confidence: 99%

Capacity evaluation for general practitioners in Pudong new area of Shanghai: an empirical study

Shu

Huang

et al. 2016

Int J Equity Health

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BackgroundBuilding highly qualified General Practitioners (GPs) is key to the development of primary health care. It’s therefore urgent to ensure the GPs’ quality service under the background of the new round of health care system reforms in China. A new model of GP qualification examination was originally implemented in Pudong New Area of Shanghai, China, which aimed to empirically evaluate the GPs’ capability in terms of clinical performance and social recognition. In the current study, an analysis was made of the first two years (2014–2015) of such theoretical and practical examinations on the GPs there with a view to getting a deep insight into the GP community so as to identify the barriers to such a form of GP qualification examination.MethodsThe agency survey method was applied to the two-year database of the GP examinees, the formative research conducted to explore the key elements for developing the examination model. The data analysis was performed with SPSS for Windows (Version 19.0) to describe the GPs’ overall characteristics, and to make comparisons between different groups.ResultsIn 2015, the total number of GPs was 1264 in the area, in different districts of which, statistically significant differences were found in sex, age, professional title and employment span (P < 0.05). Such results were found to be similar to those in 2014. The examinees’ theoretical scores were statistically different (F = 7.76; P < 0.05), showing a sloping trend from the urban district to the suburban, to the rural and then to the farther rural, as indicated by LSD-t test (P < 0.05). From the theoretical examinations the scores were higher on the western medicine than on the traditional Chinese medicine (F = 22.11; P < 0.05).ConclusionsAs suggested by the current study on the GPs’ qualification examination, which was pioneered in Pudong New Area of Shanghai, the construction of GP community was far from sufficient. It was a preliminary study and further studies are merited along the construction and development in terms of continuing medical education, performance appraisal and incentive mechanism.

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Factors Influencing Patients’ Contract Choice With General Practitioners in Shanghai

Cited by 30 publications

References 8 publications

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

An evaluation of the effects of general practitioner–supported patient noncommunicable diseases control model in Shanghai, China

Capacity evaluation for general practitioners in Pudong new area of Shanghai: an empirical study

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