Implementation status quo of contractual family doctor system based on hierarchical diagnosis and treatment in Changsha City / 重庆医学

ABSTRACT

Objective To investigate the implementation status quo of the contracted family doctor system in Wangcheng District of Changsha City. Methods Sixty-three health workers and 185 medical residents were selected from 6 township health centers in Wangcheng district which implementing the contracted family doctor system and performed the questionnaire survey on the implementation status quo of the contracted family doctor system and its influencing factors.. Implementation status of contracted family doctor system and its influencing factors were investigated by using questionnaires. Results The total satisfaction of the residents in Wangcheng District to township hospitals was 49.44%;the satisfaction differences to different institutions were analyzed,the results showed that the medical environment, service attitude and medical equipments had statistical difference among 6 township health center(P<0.05);Logistic regression analysis results showed that queuing time for consultation, medical price, service attitude, explain of disease state,technological level and medical effect were the main influence factors affecting the residents' satisfaction (P<0.05) ;the development prospects,distribution of workload and time, equity and work risk were the influence factors for the medical workers' satisfaction (P<0.05). Conclusion Many problems and influencing factors exist in the implementation process of the contracted family doctor system in Wangcheng District, which can be perfected in the aspects of the job responsibility of family doctors,performance assessment of family doctors and distribution of medical insurance reimbursement ratio.