Willingness of patients with chronic disease in rural China to contract with family doctors: implication for targeting characteristics

作者：Jie Li, Jie Li, Peipei Fu, Yan Chen, Xue Tang, Zhixian Li, Shijun Yang, Yan Chen, Wenjuan Li, Zhen Gui, Chengchao Zhou · 发表于：BMC Family Practice · 年份：2021 · DOI：10.1186/s12875-021-01553-2 · 被引用次数：23 · 研究领域：Healthcare Systems and Reforms、Primary Care and Health Outcomes、Healthcare Policy and Management

BACKGROUND: Rural residents with chronic conditions have a stronger need for health services, which should make using family doctor contract services a priority. This study aimed to evaluate the rate of willingness among rural residents with chronic conditions to contract with family doctors and examine its determinants. METHODS: A cross-sectional study was conducted from May, 2018 to June, 2018 in Shandong Province in China. A total of 769 rural unsigned residents with chronic conditions were included in the analysis. Using the Andersen model as the theoretical framework, logistic regression models were chosen to analyse the factors associated with willingness to contract with family doctors. RESULTS: This study found that the rate of willingness to contract with family doctors among chronic patients in rural Shandong was 46.7%. A higher willingness was observed in those living a further distance from the village clinic (more than 600 m: OR = 1.85, 95%CI =1.17-2.93), having received publicity for family doctor contract services (OR = 1.71, 95% CI = 1.06-2.76), reporting need for utilizing a chronic disease management program (OR = 3.36, 95% CI = 2.20-5.23), and reporting need for higher medical insurance reimbursement (OR = 1.91, 95% CI = 1.28-2.83). CONCLUSIONS: The prevalence of contract willingness was relatively low among unsigned rural residents with chronic conditions in rural Shandong, China. The need factors were powerful factors affecting their willingness to contra...