Analysis On The Willingness To Contract Family Doctor Services Among Uncontracted Rural Residents In Shandong Province,China

BackgroundThrough the family doctor contracted services.it is conducive to promoting residents'health management,strengthening disease prevention,promoting hierarchical diagnosis and treatment,and reduce medical expenses.China's rural areas are still at a disadvantage in terms of economic level and medical resources,and the contracting work of family doctors is faced with many serious challenges.Therefore,more attention should be paid to the contracting work of family doctors in rural areas.ObjectiveTo understand the situation of family doctor contracted services of rural residents in Shandong Province;to explore the factors affecting the willingness of uncontracted rural residents in Shandong Province;to analyze the reasons for residents'unwillingness to contract family doctor services;to put forward countermeasure and the suggestion for increasing the signing rate of family doctors in rural areas of Shandong Province;to provide an empirical reference for government departments to further improve family doctor services in rural areas.MethodsIn this study,180 villages in six counties in three cities in Shandong province were randomly selected,with a total sample number of 2,979 among which 2.152 rural residents didn't contract family doctor services.Using Epidata3.],Stata 14.0.SPSS24.0 for data entry and analysis,through descriptive analysis to understand the basic situation of Shandong province rural residents who did not contract family doctor services,using Logistic regression to analyze the factors that influence the willingness of rural residents to contract family doctor services,using Andersen health services utilization model to explore the impact of various factors on the willingness to contract family doctor services.Finally,Mplus8.3 was used to construct a path analysis model to explore the potential relationship between related variables.ResultsOf the 2,152 rural uncontracted residents in Shandong Province,1,012 people were willing to contract family doctor services,accounting for 47.03%.The Andersen health service utilization model showed that the degree of influence on the willingness to contract is in order of the enabling factor.the predisposing factor,the health behavior factor,and the need factor.We found that the rural uncontracted residents who were younger(P=0.030),who had not attended school(P<0.05),who knew more about family doctor services(P<0.05),whose village has publicized family doctor contracted services(P<0.05),whose family had children aged 0-6 years old(P=0.045),who participated in sports activities(P=0.043)had strong willingness to contract family doctor services.The three main reasons why rural unsigned residents in Shandong Province were unwilling to contract family doctor services were:(1)worrying about charging;(2)without contractual requirements for good health:(3)not understanding family doctors' contracted services.Conclusion and suggestionThe overall level of willingness of uncontracted residents to contract family doctor services was not high in rural areas of Shandong Province.In view of the research conclusions,we put forward the following suggestions:(1)Pay attention to the family doctors contracted services in rural areas,improve the willingness of rural residents to contract family doctors' services.(2)Strengthen publicity,and improve the understanding of rural residents on family doctors contracted services.(3)Develop appropriate publicity strategies for key and non-key groups.(4)Formulate the charging standard for family doctor contracted services that met the payment level of rural residents.(5)Implement post-contract service work in rural areas and increase the compliance rate of family doctors' contracted services.(6)Optimize the resource allocation of grassroots health service institutions and improve the service level of rural family doctors.