基于居民需求视角的中国家庭医生签约服务实施情况调查

A survey on the implementation of family doctor contract services in China from the perspective of resident demand.

作者信息

Zhang Yue-Ling, Yang Yuan-Can

机构信息

School of Economics and Management, University of Chinese Academy of Sciences, No. 3, South Zhongguancun Street, Haidian District, Beijing 100190, China.

College of Civil Engineering, Tongji University, No. 1239, Siping Road, Yangpu District, Shanghai 200092, China.

出版信息

Fam Pract. 2025 Jan 17;42(1). doi: 10.1093/fampra/cmae075.

DOI:10.1093/fampra/cmae075

PMID:39887068

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11783309/

Abstract

BACKGROUND

To understand the implementation of the family doctor contract service system in China from the perspective of resident demand.

METHODS

A stratified random sampling design was employed to survey 6380 residents across the eastern, central, and western regions of China. Data were processed using SPSS 22.0 and Python, and statistical methods such as chi-square and rank sum tests were applied. Multivariate logistic regression analysis was used to assess the impact of various factors.

RESULTS

(i) Overall implementation of the family doctor contract service system in China: (a) Nationwide awareness rate was 64.73%, with a contracting rate of 12.98%. (b) The overall satisfaction score for the implementation of contracted services was 3.78 out of 5, indicating general satisfaction. (ii) Regional implementation of the family doctor contract service system in the eastern, central, and western regions: (a) Awareness in the eastern region (67.76%) was higher than the national average (64.73%), while it was lower in the central region (60.44%). (b) The contracting rate in the eastern region (15.02%) was also above the national average, with the western region having the lowest rate (12.28%) but the highest willingness to contract.

CONCLUSION

The current state of implementation of China's family doctor contract service system is far from the goals set out in the "Guidance on Promoting High-Quality Development of Family Doctor Contract Services". Inadequate promotion of the system and subpar service quality post-contract have led to low public trust and satisfaction. The construction of family doctor teams and the contract service guarantee mechanism remain underdeveloped.

摘要

背景

从居民需求角度了解中国家庭医生签约服务制度的实施情况。

方法

采用分层随机抽样设计，对中国东部、中部和西部地区的6380名居民进行调查。数据使用SPSS 22.0和Python进行处理，并应用卡方检验和秩和检验等统计方法。采用多因素logistic回归分析评估各种因素的影响。

结果

（i）中国家庭医生签约服务制度的总体实施情况：（a）全国知晓率为64.73%，签约率为12.98%。（b）签约服务实施的总体满意度评分为3.78分（满分5分），表明总体满意。（ii）东部、中部和西部地区家庭医生签约服务制度的区域实施情况：（a）东部地区的知晓率（67.76%）高于全国平均水平（64.73%），而中部地区较低（60.44%）。（b）东部地区的签约率（15.02%）也高于全国平均水平，西部地区的签约率最低（12.28%），但签约意愿最高。