Demands And Needs Of Residents Signing Family Doctor Service In Nanjing Gulou District

Objective:To Investigate the needs of various types of people signing family doctor service,and analyze the influencing factors,so as to provide scientific basis for the development of personalized contract service package.Methods:A questionnaire survey was conducted between July and December 2017 among residents in Nanjing Gulou district.The questionnaire included basic information of residents,demands to sign service contract with family doctors,annual outpatient needs,demands of service mode,expectation for family doctor service,and willingness to pay.Results:A total of 420 questionnaires were distributed and 415 questionnaires were valid.Multivariate linear regression analysis suggested that age,income,and understanding of signing family doctor service were independent factors influencing signing intention(P<0.05).The variance analysis trend test indicated that the healthy people had highest willingness of signing,followed by the patients and the pregnant women(F=6.82,P<0.01).The number of annual outpatient service needs for healthy population,hypertensive patients,diabetic patients and pregnant women was(2.64±3.48),(7.02±4.80),(9.98±5.37)and(11.20±4.33)respectively(F=77.94,P<0.01).The average need of outpatient visit for health males was higher than that for females(P<0.01).There were significant differences in outpatient needs between patients with non-complicated hypertension andcomplicated hypertension(P<0.01).The most anticipated services for healthy people were health records(74.26%,101/136),medical appointments(56.62%,77/136),and physical check-up(56.62%,77/136);those were management of blood glucose,blood pressure and body weight(70.13%,108 / 154),regular testing(66.88%,103/154),follow-up supervision(66.23%,102/154)for chronic patients;those were regular physical examination(80.26%,61/76),follow-up supervision(50.00%,38/76)and health records(46.05%,35/76)for pregnant women.The most popular health communication channel is We Chat,accounting for 44.10%(183/415),followed by outpatient clinic,telephone and internet services,accounting for 37.11%(154 /415),31.57%(131/415)and 11.08%(46/415)respectively.Among those who chose We Chat,81.4%(149/183)were under 45 years old.And 86.27%(358/415)of people were willing to pay for corresponding signing fees.Conclusion:1.Residents' willingness to pay for family doctors services is generally higher,and most signers are willing to pay a contract fee of <200 yuan/person/year.2.Young people,high-income people,and residents who understand contracted services are more likely to accept family doctor contracting services.3.Young and highly educated contractors prefer to use networked tools to communicate with family doctors,while older people prefer to use traditional outpatient services to communicate with family doctors.4.For outpatient service needs,women are higher than men,patients with diabetes are higher than patients with hypertension,and patients with multiple chronic diseases are higher than patients with only one chronic disease.When designing outpatient service needs for signers,family doctors should consider the gender,types and number of chronic diseases of signers.5.Residents of different health conditions expect different family doctor services,and different contracted service packages with different design priorities can help meet the contracting needs of different groups of people with limited contract fees.Suggest:1.Increase the publicity of family doctors' signing service system.2.Family doctors use personalized service methods according to people of different cultures and ages.3.Designing targeted contract packages for different groups of people.4.Based on the principle of health management,further research on the rational quantification of each item in the contract service package.