School of Public Health, Hangzhou Normal University.
School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2021 Aug 13;100(32):e26887. doi: 10.1097/MD.0000000000026887.
China encourages medical staff from non-primary hospitals (higher-level hospitals) to participate in and provide Family Doctor Contract Service (FDCS) due to a lack of primary medical resources in community health service centers. This study aims to explore the factors affecting the willingness of family doctor contracting from the tertiary hospital medical staff's perspective. An anonymous self-administered survey was conducted among the medical staff from tertiary hospitals in Hangzhou, Zhejiang Province. Information of the socio-demographic characteristics, the willingness of participating in FDCS and its related reasons, and factors that might affect willingness were investigated. A multivariate logistic regression was used to identify the statistically significant variables associated with willingness. A total of 346 medical staff were recruited in the survey, and 37.86% of them were willing to participate in and provide FDCS. Medical staff with the following characteristics had stronger will: (1).. with higher education level; (2).. having better knowledge with family doctor; (3).. being more attracted by the national policy of FDCS; (4).. thinking it help for income increase. The majority of willing doctors (25.95%) believed that participating in FDCS could help them achieve their personal value, and the reason chosen most for unwilling reason was “low income and unrealized personal value (32.21%).” It is necessary for the government to establish the essential matching mechanisms to guarantee the development of the family doctor, including increasing the final financial support for primary health facilities, and developing the national incentive mechanism for family doctors.
中国鼓励非基层医院(上级医院)的医务人员参与并提供家庭医生签约服务(FDCS),因为社区卫生服务中心缺乏基层医疗资源。本研究旨在探讨从三级医院医务人员的角度影响家庭医生签约意愿的因素。对浙江省杭州市三级医院的医务人员进行了匿名自填式调查。调查了社会人口统计学特征、参与 FDCS 的意愿及其相关原因,以及可能影响意愿的因素。采用多变量逻辑回归分析确定与意愿相关的统计学显著变量。共有 346 名医务人员参与了调查,其中 37.86%的人愿意参与并提供 FDCS。具有以下特征的医务人员有更强的意愿:(1)..具有较高的教育水平;(2)..对家庭医生有更好的了解;(3).. 更受 FDCS 国家政策的吸引;(4).. 认为这有助于增加收入。大多数愿意参与的医生(25.95%)认为参与 FDCS 可以帮助他们实现个人价值,而不愿意参与的主要原因是“收入低,个人价值未实现(32.21%)”。政府有必要建立基本的配套机制来保障家庭医生的发展,包括增加对基层卫生机构的最终财政支持,以及制定国家家庭医生激励机制。