Health Management School, Inner Mongolia Medical University, Jinshan Development District, Huhehaote, 010110, China.
School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing, 100875, China.
BMC Prim Care. 2024 Feb 15;25(1):58. doi: 10.1186/s12875-024-02298-4.
China is implementing the family doctor (FD) system to reform the primary healthcare (PHC). The family doctor contract service (FDCS) policy plays a crucial role in this system implementation, aiming to transform the doctor-patient relationship and enhance PHC quality. This study aims to investigate the impact of FDCS on the doctor-patient relationship in PHCs using field research methodology.
The field research methodology was employed to address the research questions. Quantitative methods were utilized for data collection and analysis. A structure questionnaire was used to collect data based on the research questions. Our investigation encompassed twenty-five village clinics across three counties in China. A total of 574 subjects helped us to finish this investigation in the study. The collected data was analyzed using statistical analysis including ordinary least squares (OLS) model and propensity scores matching model (PSM) to estimate the relationship.
The findings from ordinary least squares (OLS) regression revealed that FDCS had a positive influence on patient trust in doctors within PHCs, with patients who participated the FDCS exhibiting higher levels of trust compared to those who did not participate. Propensity score matching (PSM) analysis further confirmed these results by accounting for selection bias.
The implementation of family doctor contract service has brought about significant transformation in the doctor-patient relationship within rural Chinese PHCs. In essence, it has revolutionized the service model of doctor in PHC, playing a pivotal role in improving primary health quality and enhance the service capability of doctors in PHC. This transformative process has been crucial for carrying out hierarchical diagnosis and treatment policy, which aims to adjust the medical service structure and optimizing the health service system. Therefore, it is imperative for government authorities and health administration departments to ensure continuous support for this essential service through appropriate formulation.
中国正在实施家庭医生制度以改革基层医疗保健。家庭医生签约服务政策在这一制度的实施中起着至关重要的作用，旨在转变医患关系，提高基层医疗保健质量。本研究旨在运用实地研究方法，调查家庭医生签约服务对基层医疗机构医患关系的影响。
采用实地研究方法来解决研究问题。使用定量方法收集和分析数据。根据研究问题，我们使用结构问卷收集数据。我们的调查涵盖了中国三个县的 25 个村诊所。共有 574 名研究对象参与了本次调查。使用统计分析（包括普通最小二乘法（OLS）模型和倾向评分匹配模型（PSM））来分析收集的数据，以估计关系。
普通最小二乘法（OLS）回归的结果表明，家庭医生签约服务对基层医疗机构中患者对医生的信任产生了积极影响，参与家庭医生签约服务的患者比未参与的患者表现出更高的信任度。倾向评分匹配（PSM）分析进一步通过考虑选择偏差来证实了这些结果。
家庭医生签约服务的实施在农村中国基层医疗机构的医患关系中带来了重大变革。从本质上讲，它彻底改变了基层医疗保健医生的服务模式，在提高基层医疗质量和提高基层医疗保健医生的服务能力方面发挥了关键作用。这一转型过程对于实施分级诊疗政策至关重要，该政策旨在调整医疗服务结构和优化卫生服务体系。因此，政府和卫生行政部门有必要通过适当的制定来确保对这项基本服务的持续支持。
