Evaluation Study Of Family Physician Quality Based On Patients’ Trust

Objective:The family physician contract services is not only an important work for grassroots health institutions,but also the core content of the national medical reform in recent years.This study aimed to analyze the trust in the family physician and understand the utilization of family physician contract services among the signed-family,and to explore its influencing factors.It was also to offer policy recommendations and provide scientific basis for improving t he work quality of family physician.Methods:On the basis of reviewing literature and expert consultation,questionnaire survey was conducted to collect the data.A simple random sampling method was used to select 3 community health centers(CHCs)in Fuyong street,Shenzhen.From July 2016 to September 2017,a questionnaires was conducted on the signed-family and non-signed family of the selected CHCs.Finally,1000 signed-family questionnaires were distributed and 900 questionnaires were responded(response rate 90.00);1000 non-signed family questionnaires were distributed and 956 questionnaires were responded(response rate 95.60).Data entry was conducted with Epi Data 3.1 software,data analysis was performed using SPSS 17.0 software package.Descriptive analysis,Chi-square and logistic regression model were conducted to explore the influencing factors of signed-family trust in family physician.Results: 1.Comparison of the trust in physician among signed-family and non-signed family61.11% of signed-families reported that they had higher trust in family physician(≥40),and the signed-family’ trust in family physician was higher than the non-signed family’ trust in general practitioner(GPs).2.Analysis of the utilization of family physician contract service,demand and renew will72.67% of the signed-families received clinical services,62.11% of the signed-families used telephone reservation.The rates of the utilization of chronic disease management(17.67%)and health assessment(15.22%)were low.The main health demands of the signed-families were to develop healthy diet and good living habits(75.33%),guidance of reasonable exercise(67.44%)and periodic measure blood pressure and blood glucose(51.78%).91.11% of the signed-families willing to renew with the family physician,attend clinics more convenient will be the major cause(88.90%).3.Current status of assessment of family physician medical serviceThe average score of service attitude was 92.24(SD=8.03).373(41.44%)signed-families were familiar with the family physician.The average frequency of family physician actively contacting the signed family in the past year was 1.37(SD=1.92).651(72.33%)signed-families thought the family physicians were more carefully than general practitioner.The rate of the satisfaction of family service was 89.67%(807 signed-families).4.Study on the influencing factors of signed-family trust in family physicianTaking the trust score of the family physician as dependent variable and 11 factors(the demographic characteristics of the signed-family,the signed-family’s utilization and willingness of family physician,and the evaluation of family physician’s medical services)as independent variable,logistic analysis was conducted to explore the influencing factors of signed-family trust in family physician.The results showed that the service attitude,frequency of screening,familiar with family physician and the rate of satisfaction were the significantly associated with the trust in the family physician.Signed-families who were familiar with family physician(OR=1.462,95%CI=1.043-2.050)and satisfied with the family physician’s work(OR=3.675,95%CI=2.041-6.617)had higher trust score.The better service attitude(OR=1.077,95%CI=1.053-1.101)and follow-up times(OR=1.211,95%CI= 1.101-1.331)always lead to higher trust points.Conclusions and suggestions:With the progress on family physician contract service,the recognition and trust degree of family physician was high,family physician achieved definite progress.The signed-family showed active willingness to re new,but the rate of the utilization of family physician service was low.The service attitude,frequency of screening,familiar with family physician and the rate of satisfaction were the significantly associated with the trust in the family physician.It was suggested that the leadership of the organizational should be strengthened.In addition,promptly implementing support policies,increasing publicity,constructing the information technology,increasing the rate of renew,implementing financial subsidies and perfecting examination mechanism were also needed,so as to guarantee normative development of family physician contract service.