Preliminary Study On The Signing Status Of Family Physician And Its Influencing Factors In Shenyang

Objective: to understand the current implementation status of family physician contract signing service in Shenyang City,explore the factors influencing residents’ contract signing behavior,and provide meaningful reference for further promoting the development of this service.Methods: From November 2020 to February 2021,a cross-sectional survey was conducted in one community health service center in each district of five old urban areas in Shenyang,which has been carrying out family doctor contract service.The investigators of the selected community health service center conducted a questionnaire survey on the patients in the community with the method of convenient sampling.The survey mainly includes basic information,health status and medical information,cognition and attitude of residents,service utilization effect and satisfaction of contracted residents,service demand and willingness of non contracted residents.Epidata3.1 was used to input data,spss23.0was used for descriptive statistical analysis,t-test,chi square test and multivariate regression analysis.Results:1.Among the 999 community residents,285(28.5%)self-reported contract signing residents,and the self-reported contract signing rate was 28.5%.The average age of the contract signing group was 61.13 ± 11.49 years old,and that of the non contract signing group was 57.15 ± 12.59 years old.The age of the contract signing group was higher than that of the non contract signing group(P < 0.05).2.Univariate analysis combined with multivariate analysis found that there were 10 factors influencing residents’ contract signing behavior,which were age,current / pre retirement occupation,family per capita monthly income,preferred medical institutions,whether there were familiar doctors in the community,walking time to community health institutions,understanding of the concept of "family doctor service" and whether family doctors needed standardized training It is believed that family doctors should have the level of education and that the role of family doctor service team in improving the convenience of medical treatment.3.Through comprehensive analysis of the survey results,it is considered that the important reason for residents to sign a family doctor and make the first diagnosis in the community health service center is the convenience and accessibility of medical treatment.4.The demand for health services of the residents who have not signed the contract is not low.The main reason for not signing the contract is that they do not know and do not understand,rather than that they do not need family doctors to carry out health management.The results of univariate analysis combined with multivariate analysis showed that whether a family doctor was needed for health management was the main factor affecting the willingness of non contract residents to sign a contract.5.Most of the contracted and non contracted residents were satisfied with the service provided by the community health service center,and they were willing to renew or sign the contract.They are not satisfied with the service provided by the community mainly because of the lack of drugs and the poor medical environment and equipment in the community.Conclusion:The survey found that there were 10 factors influencing the contract signing behavior of residents in Shenyang community,which were age,current / pre retirement occupation,family per capita monthly income,preferred medical institutions,whether there were familiar doctors in the community,walking time to community health institutions,understanding of the concept of "family doctor service",and whether family doctors needed standardized training,It is believed that family doctors should have the level of education and the role of family doctor service team in improving the convenience of medical treatment.One of the important reasons for residents to sign family doctors and make the first diagnosis in community health service centers is the convenience and accessibility of medical treatment.The residents who have not signed the contract also have a large demand for health services.The main reason for not signing the contract is that they do not know and do not understand.Most of the contracted and non contracted residents were satisfied with the service provided by the community health service center,and they were willing to renew or sign the contract.