Influencing Factors And Countermeasures Of Residents’ "Signing But Not Contracting" Problem In Family Doctor Contract Service

The report of the 19th National Congress of the Communist Party of my country pointed out: "The main contradiction in our society has been transformed into the contradiction between the people’s growing needs for a better life and unbalanced and inadequate development." With the improvement of living standards,people’s needs for health are not No longer limited to physical,but the pursuit of spiritual and psychological health.Family doctor contract service can play a good role in improving the management level of grass-roots health institutions,effectively deploying medical and health personnel,preventing diseases and ensuring the health of residents.At present,my country’s family doctor contract service is developing rapidly.While achieving remarkable results,it also faces many challenges.The problem of residents’ "signing but not contracting" in the family doctor contract service is one of the more prominent problems.As the demand side of medical services,residents will not actively contact family doctors for help after signing with them,which not only causes waste of medical and health resources,but also adversely affects the development of family doctors’ contracted services in China.Therefore,we will deeply explore the factors that affect the "signing but not contracting" problem of residents in the family doctor contract service,find out the reasons that lead to the problem of residents’ "signing but not contracting",and put forward appropriate and reasonable countermeasures and suggestions.Better implementation plays an important role.The paper expounds the relevant theories and related concepts;takes the Anderson health service model as the theoretical framework to design a questionnaire for the problem of residents’ "signing but not contracting" in the process of contracting family doctors to provide services.According to the Anderson health service model,the dependent variable is set as "" Signing but not contracting”,set the independent variables as “scenario characteristics”,“individual characteristics(propensity factors,enabling factors,demand factors)”,“signing results”;taking residents of Zhenjiang as the survey object,From January to February,2022,12 communities in three districts and counties of jurong city,Jingkou District and Danyang City were selected by multi-stage random stratified sampling method,and 480 questionnaires were distributed.27 invalid questionnaires were eliminated,and finally 453 questionnaires were obtained,with an effective recovery rate of 94.17%.Finally,the statistical analysis software SPSS 23.0 is used to input the data,and the data are analyzed by descriptive analysis,chi-square test and binary logistic linear regression,explore the factors that affect residents’ "signing but not contracting" problem in the process of contracting family doctor services,and analyze the factors Find out the reasons for the problem of residents’ "signing but not contracting" in the process of family doctor contract service,so as to put forward practical suggestions for the further development of family doctor contract service in my country.The research conclusions of this paper are as follows:(1)The manifestations of the problem of residents’ "signing but not contracting" in the family doctor contract service are as follows: the degree of trust in the family doctor’s ability is low,the frequency of the contracted residents’ initiative to contact the family doctor is less,and the residents have less confidence in the family doctor’s ability.Unfamiliar with family doctor-related policies;(2)Education level affects residents’ contracting behavior.People with higher education levels will take the initiative to contact family doctors for help;(3)The awareness of family doctors affects residents’ signing behavior.The higher the awareness of family doctors,the more they will contact family doctors for help.(4)Whether or not chronic diseases affect residents’ signing behavior,residents with chronic diseases will take the initiative to contact family doctors for help;(5)The health status affects the residents’ contracting behavior,the worse the health status is(6)The time spent walking to community medical and health institutions affects residents’ contracting behavior.The shorter the time residents spend in community medical and health institutions,the more they will take the initiative to contact family doctors for help;(7)The choice of medical treatment affects the signing behavior,and the residents will take the initiative to contact the family doctor for help when they are unwell;(8)The service attitude affects the signing behavior of the residents.The better the family doctor’s service attitude,the more the residents will actively seek the help of the family doctor;(9)communication time affects residents’ signing behavior.The longer the communication time is,the more residents will actively seek help from family doctors.In order to solve the problem of residents "signing but not contracting" in the process of contracting family doctors to provide services,this paper proposes: strengthening the resource allocation of primary medical and health service institutions;enriching the training links of family doctors;combining online and offline to promote the family doctor system;helping residents Establish self-health management awareness;cultivate residents’ correct concept of medical treatment;reform family doctors’ salary system and incentive measures;help family doctors establish good communication with residents and other countermeasures.