Analysis Of The Impact Of Family Doctor Contract Service On Patient Experience In Typical Areas

Objective :To sort out the policies and practices of family doctor contract service in typical areas,compare and analyze the differences and causes of patient experience scores of core features of general practice between contracted and uncontracted patients,and provide reference for further promoting the development of family doctor contract service and improving patient experience.Methods :Through the expert consultation method,Ningbo City,Zhejiang Province and Jiaxian County,Henan Province were selected as the typical areas of this study.Two-stage cluster random sampling and simple random sampling were used to determine the sample institutions(township hospitals and community health service centers),a questionnaire survey was conducted on patients in primary health care institutions by using the simplified version of the Patient Experience Scale(ASPC).A total of 20 primary health care institutions were selected in Ningbo City,and 574 valid questionnaires were collected.A total of10 primary health care institutions were selected in Jiaxian County,with 274 valid questionnaires,accounting for 95.7 % and 91.3 % of the total number of surveys.The surveyed patients were divided into contracted and non-contracted groups.The independent sample t test was used to compare the patient experience scores of contracted and non-contracted patients.Multiple linear regression analysis was used to analyze the influence of related factors on the scores and total scores of each dimension of patient experience.Results :1.The total score of contracted patients in Ningbo(78.11 ± 14.32)was higher than that of uncontracted patients(59.36 ± 17.94)(t = 11.819,P < 0.001).The total score of contracted patients in Jiaxian(82.52 ± 14.98)was higher than that of uncontracted patients(58.39 ± 15.09)(t = 13.116,P <0.001).The scores of patients ’ experience in all dimensions of contracted patients in both places were higher than those of non-contracted patients,and the differences were statistically significant(P < 0.001).2.The results of univariate analysis of patient experience scores and total scores in Ningbo showed that age,composition of chronic diseases and contract signing were the influencing factors of patient experience(P < 0.05),and education level would affect patient accessibility experience scores(P < 0.05).The results of single factor analysis of patient experience scores and total scores in each dimension of Jiaxian County showed that age,chronic disease composition and contract signing were the influencing factors of patient experience(P < 0.05),but in accessibility and coordination,age had no significant effect on patient experience(P > 0.05).3.Using multiple linear regression analysis,after controlling age,chronic disease composition and other factors,signing still positively affected the scores and total scores of patients ’ experience in typical areas(P < 0.001);From the perspective of education level,compared with patients with high school and above education,patients with primary school and below education in Ningbo had lower patient experience scores,and there was no significant difference in the education level of patients in Jiaxian(P > 0.05);from the perspective of the composition of chronic diseases,patients with chronic diseases in Ningbo scored higher in all dimensions of experience,and patients with chronic diseases in Jiaxian scored higher in comprehensive experience.Conclusion :1.The implementation of family doctor contract service has improved the functional experience of patients ’ core characteristics of general practice.2.Patients with high school education and above and patients with chronic diseases in Ningbo have higher scores in patient experience,and patients with chronic diseases in Jiaxian have higher scores in comprehensive experience.3.The attention of contracted family doctor services in typical areas to the general population needs to be further improved.