Demands and needs of patients signing family doctor service in Nanjing Gulou district / 中华全科医师杂志

ABSTRACT

Objective To investigate the demands and needs of patients contracting for family doctor service in Nanjing Gulou district. Methods A questionnaire survey was conducted between July and December 2017 among residents in Nanjing Gulou district. The questionnaire included basic information of residents, willingness to sign service contract with family doctors, annual outpatient needs, demands of service mode, expectation for family doctor service, and willingness to pay. Results A total of 420 questionnaires were distributed and 415 questionnaires were valid. Multivariate analysis of variance suggested that age, income, and understanding of signing family doctor service were independent factors influencing signing intention (P<0.05).The variance analysis trend test indicated that the healthy people had highest willingness of signing, followed by the patients and the pregnant women (F=6.82, P<0.01). The number of annual outpatient service needs for healthy population, hypertensive patients, diabetic patients and pregnant women was(2.64±3.48),(7.02±4.80),(9.98±5.37)and(11.20±4.33)respectively (F=77.94, P<0.01). The average need of outpatient visit for health males was higher than that for females (P<0.01). There were significant differences in outpatient needs between patients with non-complicated hypertensionand complicated hypertension (P<0.01). The most anticipated services for healthy people were health records (74.26％,101/136), medical appointments (56.62％,77/136), and physical check-up (56.62％,77/136);those were management of blood glucose, blood pressure and body weight (70.13％, 108/154), regular testing (66.88％,103/154), follow-up supervision (66.23％,102/154) for chronic patients;those were regular physical examination (80.26％, 61/76), follow-up supervision (50.00％, 38/76) and health records (46.05％, 35/76) for pregnant women. The most popular health communication channel is WeChat, accounting for 44.10％(183/415), followed by outpatient clinic, telephone and internet services, accounting for 37.11％(154/415), 31.57％(131/415)and 11.08％(46/415)respectively. Among those who chose WeChat, 81.4％(149/183) were under 45 years old. And 86.27％(358/415)of people were willing to pay for corresponding signing fees. Conclusion Age, income, and understanding of general practice will affect residents′ willingness to sign the service contract with family doctors. Gender, disease spectrum and number of illnesses affect residents′outpatient service needs. Individualized family doctor service should be provided for people with different health needs.