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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1487365

Influencing Factor Analysis of Family Doctor Contract Service Among Older Adults: Evidence from China

Provisionally accepted
Shiyu Xie Shiyu Xie 1Zihan Ni Zihan Ni 1Xiya Yang Xiya Yang 1Ningze Xu Ningze Xu 2*Chengfang Zhu Chengfang Zhu 3*Liting Huo Liting Huo 4*Xiuyuan Zhu Xiuyuan Zhu 1*Xiaoguang Yang Xiaoguang Yang 5*
  • 1 School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
  • 2 School of Public Health, Fudan University, Shanghai, Shanghai Municipality, China
  • 3 Wangying Community Health Service Center, Huai'an, China
  • 4 Shanghai Publishing and Printing College, Shanghai, China
  • 5 Chinese Hospital Development Institute, School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China

The final, formatted version of the article will be published soon.

    Background: Family doctor contract services are essential to primary healthcare and play a significant role in improving the health of older adults. However, contract rates among older adults vary widely. Investigating the factors influencing contract rates is crucial for optimizing policies and increasing participation in family doctor services. Methods: This study used data from Wangying Community Health Service Center, encompassing 5,684 older adults in 2018. To address the endogeneity issue arising from sample selection bias, the study utilized a 1:1 nearest-neighbor matching method for counterfactual testing, balancing potential confounding factors between the contract and non-contract groups. Subsequently, Multiple logistic regression analysis was performed on the matched data to explore the impact of gender, age, number of medical visits, and the number of chronic conditions on family doctor contract behavior.Results: Gender did not significantly impact contracting behavior. However, age, the number of medical visits, and the number of chronic diseases significantly influenced family doctor contract (β=0.457, p<0.01; β=0.286, p<0.05; β=-0.229, p<0.1). An inverted U-shaped relationship was found between age and contracting behavior (β=-0.003, p<0.01). Conclusion: The factors influencing older residents' decisions to sign up for family doctor services are complex and diverse. The conclusion of the study provides valuable reference and guidance for policymakers to further improve the family doctor contracting system and optimize contracting strategies by considering the characteristics of different older adults.

    Keywords: family doctor, Family doctor contract service, older adults, primary healthcare, Influencing factors

    Received: 28 Aug 2024; Accepted: 31 Oct 2024.

    Copyright: © 2024 Xie, Ni, Yang, Xu, Zhu, Huo, Zhu and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ningze Xu, School of Public Health, Fudan University, Shanghai, 200032, Shanghai Municipality, China
    Chengfang Zhu, Wangying Community Health Service Center, Huai'an, China
    Liting Huo, Shanghai Publishing and Printing College, Shanghai, China
    Xiuyuan Zhu, School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
    Xiaoguang Yang, Chinese Hospital Development Institute, School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.