The association of family doctor contract service and patient trust in doctor: evidence from twenty-five village clinics of three counties in rural China

Linni Gu; Xiaoying Wang; Donghua Tian

doi:10.1186/s12875-024-02298-4

The association of family doctor contract service and patient trust in doctor: evidence from twenty-five village clinics of three counties in rural China

BMC Prim Care. 2024 Feb 15;25(1):58. doi: 10.1186/s12875-024-02298-4.

Authors

Linni Gu¹, Xiaoying Wang², Donghua Tian³

Affiliations

¹ Health Management School, Inner Mongolia Medical University, Jinshan Development District, Huhehaote, 010110, China. smartgu@163.com.
² School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing, 100875, China.
³ School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai Street, Haidian District, Beijing, 100875, China. tian65216@hotmail.com.

Abstract

Background: 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.

Method: 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.

Result: 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.

Conclusions: 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.

Keywords: Contact service; Doctor-patient relationship; Family doctor; Trust.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Contract Services
Humans
Physician-Patient Relations*
Physicians, Family
Trust*