Research on the impact of family doctor contract services on the willingness of residents' first choice of medical institutions for treatment-empirical analysis based on PSM.

OBJECTIVE

The survey explored the mechanism between family doctor contract services and the willingness of residents' first choice of medical institutions for treatment in Shandong Province.

METHODS

Stratified random sampling was used to do the survey. Logistic regression model was used to analyze the influencing factors of residents' willingness to first choice of medical institutions for treatment. Propensity score matching method (PSM) was used to estimate the effect of family doctor contract services on the willingness of residents' first choice to visit medical institution for treatments.

RESULTS

(1)75.2% of the respondents contracted with family doctors and 88.9% of them used family doctor contract services. 83.8% of the respondents had the willingness to choose primary health institutions as the first choice of medical institutions and 16.2% tended to prefer hospitals for medical treatment.(2)The results of the Chi-square test showed that the signing service of family doctors, age, place of residence, population category, annual per capita income, Whether covered by medical insurance, education level, and Whether have a chronic disease condition were influencing factors for the willingness of the first choice of medical institutions.(3)The results of logistic regression analysis showed that the signing service of family doctors, place of residence, education level as influencing factors on the willingness of residents' first choice of medical institutions for treatment in Shandong Province. Place of residence, annual per capita income, age, population category, Whether covered by medical insurance and Whether have a chronic disease condition had an impact on the family doctor contract services.(4)PSM showed that average treatment effects were 0.0929, 0.1874, 0.1181between family doctor contract services and the willingness of residents' first choice of medical institutions after using kernel matching, radius matching, and nearest neighbor matching.

CONCLUSIONS

(1)The level of contracted services of family doctors is high. (2)Residents preferred primary health institution as the first choice of medical institutions for treatment. (3)Residents with different characteristics had different rates of family doctor contracting service and tended to choose primary health institution for treatment.(4)Contracting service of family doctors had a positive effect on the willingness of residents to choose primary health institution. It is suggested that government departments should play a leading role, and enhance primary health institutions supply-side service provision capacity and the stickiness of family doctor contract services on the demand side.