Influencing factor analysis of family doctor contract service among older adults: evidence from China

BackgroundFamily 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 incre...

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Main Authors: Shiyu Xie, Zihan Ni, Xiya Yang, Ningze Xu, Chengfang Zhu, Liting Huo, Xiuyuan Zhu, Xiaoguang Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1487365/full
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author Shiyu Xie
Zihan Ni
Xiya Yang
Ningze Xu
Chengfang Zhu
Liting Huo
Xiuyuan Zhu
Xiaoguang Yang
author_facet Shiyu Xie
Zihan Ni
Xiya Yang
Ningze Xu
Chengfang Zhu
Liting Huo
Xiuyuan Zhu
Xiaoguang Yang
author_sort Shiyu Xie
collection DOAJ
description BackgroundFamily 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.MethodsThis 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.ResultsGender 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).ConclusionThe 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.
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spelling doaj-art-a03afc5d7ff24e23844dd96c39e2b10e2024-11-19T05:10:12ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-11-011210.3389/fpubh.2024.14873651487365Influencing factor analysis of family doctor contract service among older adults: evidence from ChinaShiyu Xie0Zihan Ni1Xiya Yang2Ningze Xu3Chengfang Zhu4Liting Huo5Xiuyuan Zhu6Xiaoguang Yang7School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, ChinaSchool of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, ChinaSchool of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaWangying Community Health Service Center, Huai'an, ChinaShanghai Publishing and Printing College, Shanghai, ChinaSchool of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, ChinaChinese Hospital Development Institute, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaBackgroundFamily 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.MethodsThis 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.ResultsGender 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).ConclusionThe 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.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1487365/fullfamily doctorfamily doctor contract serviceolder adultsprimary healthcareinfluencing factors
spellingShingle Shiyu Xie
Zihan Ni
Xiya Yang
Ningze Xu
Chengfang Zhu
Liting Huo
Xiuyuan Zhu
Xiaoguang Yang
Influencing factor analysis of family doctor contract service among older adults: evidence from China
Frontiers in Public Health
family doctor
family doctor contract service
older adults
primary healthcare
influencing factors
title Influencing factor analysis of family doctor contract service among older adults: evidence from China
title_full Influencing factor analysis of family doctor contract service among older adults: evidence from China
title_fullStr Influencing factor analysis of family doctor contract service among older adults: evidence from China
title_full_unstemmed Influencing factor analysis of family doctor contract service among older adults: evidence from China
title_short Influencing factor analysis of family doctor contract service among older adults: evidence from China
title_sort influencing factor analysis of family doctor contract service among older adults evidence from china
topic family doctor
family doctor contract service
older adults
primary healthcare
influencing factors
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1487365/full
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