Urban Community Family Physicians Contracted Service Models And Forecasts, The Residents' Medical Expenses

The community-based family physician model is a new community health care model which tend to improve integration, continuity, coordination, appropriateness, accessibility of health care and control the medical expense in the context of rising health care costs. Signing the contract between patients and family physicians is the character of the model.Objective: As a part of the project, Strengthening Strategic Planning in the Health Sector in China, the goal of this study is to evaluate the outcomes that the Community-based Family Physician model influence medical care costs by distinguishing the difference of the indicators among different kinds of outpatients. The research would offer suggestion about the operation of the community health centre and give some help for seeking out the appropriate Chinese urban health care model.Methods: Through analysis of the total expense, visit, drug and service expense per visit among three kinds of outpatients in YULIN CHC where the model is implemented, we can understand the effect that different health care style influence medicine expense and create the time series ARMA model to predict according to the trend of the indicators.Results: The outcomes show that the outpatients who contract with the community health centre spend less money than the common ones on drugs but more on services. And the number of the contract outpatients visit rises rapidly while the common patients remain the level. It is pleasing that the rise of the contract visit per capital becomes the dominating reason for rise on visit. As a result, the expense structure of the contract patients is more2003rational than the common. The community-based family physician model has increased accessibility to care for the most vulnerable patient population by increasing the proportion of the service costs. About 50% of the electronic patients are children, so the expense for children health care is the most in service. And there is no statistic difference between the contract and the electronic record patients on medicine fee per visit but there is obviously difference on service expense. The prediction using the time series model suggests the drug expense of the contract patients per visit will remain the low level and the visit number will rapidly rise. Conclusion: we can conclude that the community-based family physician model has increased accessibility for the frail elderly and the poor through home care, improved continuity through registering with a family physician, enhanced the relationships between the patients and family physicians, and improved comprehensiveness with a holistic approach to patient care throughout the study. The model is effective on reducing the patient's medicine expense and optimizing the structure of the expense. And services are a growing source of income. On the other side, the electronic record patient model is a beneficial supplement and children can profit from the electronic record patient model.