The Relationship between Family Doctor Contract Services Policy and Perceived Participation in Primary Health Care among Chronic Disease Patients in China: The Mediating Role of the Patient Trust

Li, Xinru; Li, Jinghua; Shao, Weiya; Ma, Jingyu; Zhou, Angdi; Song, Yiwen; Zhang, Li

doi:10.1155/2023/6854131

Cited by 4 publications

(1 citation statement)

References 87 publications

(83 reference statements)

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“…In addition, several studies have indicated that compared with the reference group of patients without a family physician, hypertensive patients who receive care from their own contracted family physicians have a higher BP control rate [31]. Te family physician contract services policy also appeared to infuence the perceived participation of patients in their healthcare [32]. Healthcare utilization is the quantifcation of services utilized by individuals for the purpose of maintaining health and well-being, preventing and treating health problems, or obtaining information about one's health status and prognosis [33].…”

Section: Introductionmentioning

confidence: 99%

Exploring Residents’ Healthcare Utilization under the Family Physician Contract Service System in China: Implications for Primary Healthcare

Jing,

Zhang,

2024

Health & Social Care in the Community

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Chinese government promoted a family physician contract service system in order to establish a tiered healthcare system in June 2016, but there was little evidence to assess the policy performance. This study aimed to examine the association of family physician contract services with the healthcare utilization of community residents in urban China. A cross-sectional face-to-face survey was conducted from July to September, 2019, in four advanced and exemplary cities for family physician contract services in China. A multistage cluster random sampling method was adopted to recruit residents aged 18 and above, and a total of 1508 participants were included in this study. The count model and logit regression were adopted to examine the associations between family physician contract service and healthcare utilization, and the potential bias was addressed using the propensity score matching (PSM) method. There was an increase in number of monthly primary care visits and annual referrals for contracted residents compared to noncontracted residents. Participants who had contracted with a family physician were more likely to choose a primary healthcare facility after illness than those who had not. However, no significant change was found in the number of annual hospital admissions between contracted and noncontracted residents. Family physician contract services may effectively strengthen the use of primary care facilities by community residents and promote the formation of a tiered healthcare system in China.

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Section: Introductionmentioning

confidence: 99%

Exploring Residents’ Healthcare Utilization under the Family Physician Contract Service System in China: Implications for Primary Healthcare

Jing,

Zhang,

2024

Health & Social Care in the Community

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Analysis of factors that promote the participation of patients with chronic diseases in shared decision making on medication: a cross-sectional survey in Hubei Province, China

Hu,

Feng,

Zong

et al. 2023

BMC Public Health

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Background Shared decision making (SDM) improves the health status of patients with chronic diseases, especially in the condition of poly-medicated patients. This study aims to find the factors associated with participation of patients with chronic diseases in SDM on medication. Methods A total of 1,196 patients with chronic diseases were selected in Hubei Province of China using cluster sampling methods. The random forest method was applied to rank the importance of independent variables by Mean Decrease Gini and out-of- bag (OOB) curve. Multivariate logistic regression was used to explore the independent variables’ effect direction and relative hazard. Results In this study, 5.18% of patients used patient-directed decision making (PDM, a decision-making model led by patients), 37.79% of patients used SDM (a collaborative decision-making model by patients and doctors), and 57.02% of patients used doctor-directed decision making (DDM, or paternalistic decision making, a decision-making model led by doctors). The random forest analysis demonstrated that the top 5 important factors were age, education, exercise, disease course, and medication knowledge. The OOB curve showed that the error rate reached minimum when top 5 variables in importance ranking composed an optimal variable combination. In multivariate logistic regression, we chose SDM as a reference group, and identified medication knowledge (OR = 2.737, 95%CI = 1.524 ~ 4.916) as the influencing factor between PDM and SDM. Meanwhile, the influencing factors between DDM and SDM were age (OR = 0.636, 95%CI = 0.439 ~ 0.921), education (OR = 1.536, 95%CI = 1.122 ~ 2.103), exercise (OR = 1.443, 95%CI = 1.109 ~ 1.877), disease course (OR = 0.750, 95%CI = 0.584 ~ 0.964), and medication knowledge (OR = 1.446, 95%CI = 1.120 ~ 1.867). Conclusion Most Chinese patients with chronic diseases used DDM during their medication decision-making, and some patients used PDM and SDM. The participation in SDM should be taken seriously among elderly patients with lower education levels. The SDM promotion should focus on transformation of patients’ traditional perception and enhance their medication knowledge.

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Effect of community-based public health service on health-related quality of life among middle-aged and older adults with chronic diseases in China

Wu,

Chen,

et al. 2024

BMC Public Health

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Background The growing prevalence of non-communicable chronic diseases poses a significant public health challenge globally, particularly impacting the well-being of aging populations. This study aims to assess the impact of community-based public health service (PHS) on the health-related quality of life (HRQoL) among middle-aged and older adults with chronic diseases in China. Methods Utilizing data from the China Health and Retirement Longitudinal Study, we constructed a novel scale based on the 36-Item Short Form Health Survey (SF-36) to measure the HRQoL of middle-aged and older patients with hypertension and/or type-2 diabetes. Multivariate linear regression models with Instrument Variables and Propensity Score Matching techniques were applied to examine the effect of PHS on the HRQoL of identified chronic disease patients. Results Among 8,403 hypertensive and/or diabetic patients, only 10.98% had received PHS. After adjusting for covariates, PHS exhibited a significant association with an elevated overall SF-36 score (β = 3.539, p < 0.001). Similar effects were observed in the physical and mental component summary scores, with increases of 1.982 (p < 0.001) and 5.095 (p < 0.001), respectively. Sensitive analysis affirmed the robustness of these findings. Heterogeneity analysis revealed significant HRQoL improvements among males, females, those aged 70 and older, patients with comorbidities, and urban residents, while the effect was less pronounced in the middle-aged, those without comorbidities, or rural dwellers. Conclusion Community-based PHS has exerted a positive impact on both the physiological and psychological aspects of HRQoL among middle-aged and older chronic disease patients, with effects varying among individuals with different characteristics. Our findings advocate for enhancing the delivery and utilization of government-funded PHS, increasing health literacy, and promoting early prevention strategies for chronic diseases. Furthermore, targeted health management initiatives for patients with comorbidities and enhancements in the quality of community healthcare services, particularly in rural areas, are deemed necessary.

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The Relationship between Family Doctor Contract Services Policy and Perceived Participation in Primary Health Care among Chronic Disease Patients in China: The Mediating Role of the Patient Trust

Cited by 4 publications

References 87 publications

Exploring Residents’ Healthcare Utilization under the Family Physician Contract Service System in China: Implications for Primary Healthcare

Exploring Residents’ Healthcare Utilization under the Family Physician Contract Service System in China: Implications for Primary Healthcare

Analysis of factors that promote the participation of patients with chronic diseases in shared decision making on medication: a cross-sectional survey in Hubei Province, China

Effect of community-based public health service on health-related quality of life among middle-aged and older adults with chronic diseases in China

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