A qualitative study on the implementation status of family doctor contract services from the perspective of contracted residents
10.3760/cma.j.cn114798-20250610-00594
- VernacularTitle:基于签约居民视角探索家庭医生签约服务实施现状的定性研究
- Author:
Jianhua CHEN
1
;
Zihan PAN
;
Xue JIN
;
Wenping LI
;
Yujing SU
;
Hongjing PEI
;
Jiapei XU
;
Shan SUN
;
Chunhua CHI
Author Information
1. 北京大学第一医院全科医学科，北京100034
- Publication Type:Journal Article
- Keywords:
Family doctor;
Contract service;
Chronic disease management;
Hierarchical medical system;
Qualitative study
- From:
Chinese Journal of General Practitioners
2025;24(11):1360-1367
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the current implementation status and challenges of family doctor contract services (FDCS) from the perspective of contracted residents.Methods:This qualitative study used purposive sampling to select contracted residents from 11 primary healthcare institutions across five cities in China. Semi-structured interviews were conducted from March to December 2024, covering topics such as awareness of contracting, service experience, health needs, service continuity, and policy recommendations. Thematic framework analysis was applied to organize, code, and summarize the data.Results:A total of 25 contracted residents were interviewed (6 men, 19 women; 11 from central urban areas, 14 from suburban or rural towns; 8 with chronic diseases). Three main themes and ten sub-themes emerged: Theme Ⅰ: Pathways to improved service accessibility (optimized chronic disease management, more efficient referrals, and improved health education). Theme Ⅱ: Structural misalignment between supply and demand (limited specialty services despite patient needs, insufficient coverage and public awareness of home-based medical care, imbalanced human resources, and service disruption due to clinician turnover). Theme Ⅲ: Challenges in service awareness and communication mechanisms (information asymmetry and public misperception regarding FDCS, perverse incentives in administrative performance evaluation, and communication barriers in building patient-doctor trust).Conclusions:While FDCS has shown progress in chronic disease management, referral coordination, and health education, structural supply-demand gaps and communication challenges continue to hinder service quality. Improvements in resource allocation and service models are needed to support high-quality development.
