Evaluation and countermeasures of the contracted services of Chinese family doctors from the perspective of demanders -- a case study of a city

Background: From the perspective of the demander, the purpose of the study is to find out the weak link of the family doctor contracted service in a city, that is, to optimize the effect of the family doctor contracted service in China. Methods: In this study, a city in Shandong Province, China was selected as the sample city. In January 2020, 1098 contracted residents (including 40.5% men and 59.5% women) from 18 primary medical institutions (including township health centers and community health centers) were selected for on-site investigation. The PCAT-AS scale revised in Chinese was used as the research tool to understand the treatment experience of contracted residents in primary medical institutions. Results: Among the four core dimensions of PCAT-AS, the score of Continuous was the highest (3.44 ± 0.58); The score of Coordinated was the lowest (3.08 ± 0.66); Among the three derived dimensions, the score of Family-centeredness was the highest (3.33 ± 0.65); The score of Culturally-competent was the lowest (2.93 ± 0.77). The PCAT scores of contracted residents with different demographic characteristics such as contracted institution, age, education level, marital status and occupation were statistically significant (P < 0.05). Conclusions: The family doctor contracted service in the city has achieved certain results. At the same time, there are still some problems, such as difficult access to outpatient services during nonworking hours and incomplete service items. It is suggested that primary medical institutions further improve their service capacity in the dimensions of Coordinated and Comprehensiveness, in order to provide better services for contracted residents.