ArticleBMC primary care2022
Can the implementation of family doctor contracted service enable the elderly to utilize primary health care services more equally? empirical evidence from Shandong, China.
Article in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Willingness to maintain contracts with family doctors among Chinese residents: results from one national cross-sectional study and a meta-analysis of 25 studies.Frontiers in public health · 2023Pooled it
- Construction of an index system for workplace services by family doctors in China: a two-round Delphi study.BMC primary care · 2026Article
- Urban-Rural Differences of Impact of the Accessibility of Community Older Adult Care Services on the Quality of Life of Older Adults.International journal of public health · 2026Article
- Strengthening primary care gatekeeping for healthy aging in China: family doctor contract service and multidimensional health outcomes among older adults.Frontiers in public health · 2026Article
- Article
- Research on the impact of family doctor contract services on the willingness of residents' first choice of medical institutions for treatment-empirical analysis based on PSM.BMC health services research · 2025Article
- A mediation analysis of family members' knowledge, attitudes, and practices in nutritional and dietary management for gastric cancer patients.Frontiers in medicine · 2025Article
- Article
- The association between family doctor contract services and the health of middle-aged and older people in China: an instrumental variables analysis.Scientific reports · 2024Article
- Can family doctor system improve health service utilization for patients with hypertension and diabetes in China? A difference-in-differences study.BMC health services research · 2024Article
- Depressive symptoms of older adults with chronic diseases: the mediating roles of activities of daily living and economic burden of diseases.Frontiers in psychology · 2024Article
- Study on the evaluation and influencing factors of contracted residents on the coordination of primary medical institutions.Frontiers in public health · 2024Article
- Current Status and Factors Influencing Emergency Response Capability of Shared Nurses in the Internet + Nursing Service Model: A Descriptive Cross-Sectional Study.Risk management and healthcare policy · 2024Article
- Trends in health service needs, utilization, and non-communicable chronic diseases burden of older adults in China: evidence from the 1993 to 2018 National Health Service Survey.International journal for equity in health · 2023Article
- Examining coordination and equilibrium: an analysis of supply index and spatial evolution characteristics for older adult services in Zhejiang Province.Frontiers in public health · 2023Article
- Article
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4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile the elderly are facing greater health risks, they also face more serious inequalities in utilization of medical services. The family doctor contracted service is the core policy of the Chinese government to cope with aging and to achieve the outcome that everyone has the right to primary health care. However, previous research has neither revealed the degree of inequality in the use of contracted services among the elderly in China, nor has it revealed what factors are related to the inequality in the use of services.
objectiveAssess and decompose the inequality in the use of family doctors contracted services in the elderly population in China.
methodsA cross-sectional study of 1037 elderly people was conducted in Shandong Province, China. According to the first consultation rate of family doctors, the physical examination rate, the healthy lifestyle guidance rate and the chronic disease management rate, the situation of elderly people's utilization of family doctor contracted service was investigated. The concentration index is used to measure the degree of inequality in the use of family doctors contracted services by the elderly. In order to test the contribution of different factors to the inequality of utilization of family doctors contracted services, the concentration index was also decomposed.
resultsThe first consultation rate of family doctors for the elderly in Shandong Province was 24.6%, the physical examination rate was 65.8%, the healthy lifestyle guidance rate was 13.7%, and the chronic disease management rate was 52.2%. The horizontal inequality index of the healthy lifestyle guidance rate and the chronic disease management rate were 0.451 and 0.573, respectively, indicating that there is an inequality of pro-wealth. The concentration index of physical examination rate and chronic disease management rate is negative (- 0.260, - 0.518), which means inequality to the poor. Education level is the most important factor affecting the unequal utilization of health services for the elderly, followed by income.
conclusionThe family doctor contracted service has had a positive impact on alleviating the health inequality in the utilization of basic medical and health services for the elderly. Although there is still inequality in terms of pro-wealth for the elderly, the utilization of family doctor contracted service has weakened the inequality of service utilization brought about by income. Enhancing the health literacy of the elderly, narrowing the gap between the rich and the poor, bridging the gap between urban and rural areas, and building a harmonious family relationship can promote the realization of basic medical and health care services for every elderly.
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