Study On The Implementation Of Contract Service Policy For Family Doctors In Z County Based On Massa Model

In order to deal with the threat of public health care in China,such as the aging population,the surge in the number of chronic patients,and the high medical costs,as well as to alleviate the problems of inadequate and unbalanced supply of medical and health services,the lack of primary medical resources,and the "difficulty and high cost of seeing a doctor" for a long time,China has vigorously implemented the family doctor contract service policy since2016,Through the establishment of Contractual service relationship,family doctors can provide convenient,effective,economic and sustainable health care and health management services for contracted residents,so as to improve the health status of residents,prevent and resolve the risk of major diseases,and realize the reasonable control of medical expenses.It is of far-reaching practical significance to implement the policy of family doctor contract service.After years of policy practice,even though governments at all levels,medical institutions at all levels and family doctor service teams have invested a lot of energy,the implementation effect is still unsatisfactory and the policy implementation is stagnant.Through literature review,it is found that the existing research on family doctors in China is very few from the perspective of policy implementation,and the existing research is widely concentrated in the early and mature developed cities,while the grassroots research on the later development of family doctors is still very little.The grassroots family doctors have their own particularities in personnel composition,service content,service quality,satisfaction and other aspects,so it is of practical significance to study the implementation of Grassroots Family Doctors’ contracted service policy.Therefore,this paper chooses the implementation of family doctor contract service policy in Z County as the research object to explore the grassroots experience of family doctor contract service policy implementation.Based on this,this paper adopts the method of stratified sampling,selects six villages and towns in Z County as the survey sample,through the form of questionnaire and interview,investigates and analyzes the implementation effect of family doctor contract service policy in Z County.The results show that the implementation of family doctor contract service policy in Z County has achieved certain results in the number of contract signing and health management,but there are obvious deficiencies in medical fee control,referral service and target group satisfaction.In this regard,in the framework of Massa model,this paper analyzes the influencing factors of the implementation effect of family doctor contract service policy in Z County from three aspects: the manageability of policy issues,the regulation ability of the policy itself and other variables.Finally,under the guidance of gradualism theory,the paper puts forward suggestions to optimize the implementation of family doctor contract service policy in Z County.