Study On The Influencing Factors Of People's Willingness To Adopt Family Doctor Signing Service

With the rapid economic development in China,people's living standards are constantly improving,and people are increasingly concerned about their own health,thus the demand for medical and health services is growing.The implementation of the family doctor system is an important measure for the reform of the primary medical and health service model in China,and also a major solution to the social problems such as the aging of the population and the difficulty of seeing a doctor.In June 2016,China issued the guidance on promoting the service of signing family doctors to promote and standardize the signing service of family doctors.However,there are many difficulties in the implementation of family doctor system in China,and this paper attempts to study which factors affect residents' willingness to adopt the service of signing family doctors.According to the government files,the study summarized the four types of family doctors contract services:basic medical services,public health and health management services,medical treatment process optimization services and "Internet plus" medical services.The sample was selected from Jintan District of Changzhou City,and the business processes were extracted from four types of business.Based on the touch point theory,expected value theory and perceived risk theory,this paper constructs a model of influencing factors of willingness to adopt the service of signing family doctors.It takes 4 touch points with the primary hospital including outpatient medical service,the outpatient medical environment,doctor-patient relationship level,and medical expenses level,and the urgency of demand as independent variables,and studies the effect of these independent variables on user's expected value,so as to study the impact of user's expected value and user's perceived risk on user's willingness to sign up.In this paper,224 valid questionnaires were collected from the resident population of Jintan District,and the structural equation model was tested by SPSS and smart PLS.It is found that both the medical level in primary hospital's outpatient service and doctor-patient relationship have a significant impact on the user's expected value on the service of signing family doctors,while the medical environment and the level of medical expenses have no impact on the user's expected value of;the urgency of user demand and the user's expected value have a significant impact on the user's willingness to sign a contract,while the perceived risk has no impact on the user's willingness to sign a contract.At the same time,when the four touch point variables interact with the urgency of the user's demand,only the outpatient medical level*the urgency of service demand shows a certain marginal significance among the four touch point variables,and the other three cross variables are not significant.In addition,for the sample individual variables,compared with the residents with high education,the residents with low education have stronger willingness to sign a contract;compared with the residents with single primary hospital treatment channel,the residents with multiple primary hospital treatment channels have stronger willingness to sign a contract;the people with chronic diseases have stronger willingness to sign a contract than other types of people.Based on the above data analysis results,the outpatient medical level of primary hospitals(including the professional level of doctors and the level of hospital hardware)is one of the main factors for users to sign up for family doctor services.However,compared with general practitioners in developed countries,there is still a long way to go in the cultivation of comprehensive quality of doctors in primary hospitals of China.At the same time,the doctor-patient relationship is another major consideration for users to sign up for family doctor services.Good relationship between doctors and patients is an important driving force for users to adopt fixed family doctor services,and has a psychological soothing effect on patients with chronic diseases.In addition,the willingness to sign contracts varies with individual differences,which are,people with low education level,diversified treatment channels and chronic diseases,significantly have strong willingness to sign contracts.It also reflects the rationality of giving priority to the coverage of people with chronic diseases such as hypertension,diabetes,tuberculosis,etc.in the family doctor service system.In this paper,through the establishment of a theoretical model of the factors that affect people's willingness to sign up for family doctors services,and through questionnaire research,we can provide some theoretical reference and countermeasures for promoting the signing services of family doctors in China.However,the sample object of this study is in Jintan District,Changzhou City,which is a leading and successful case in the implementation of family doctors signing service.It is not necessarily representative and universal in the third-class areas.In future study,the sample size can be expanded,and samples can be collected and analyzed in different economic development levels and different health management levels.This paper can provide some practical basis for pilot regions to improve the signing rate of family doctors and enhance the service effect of family doctor.