ArticleBMC geriatrics2024
Does contracting family doctor promote primary healthcare utilization among older adults? - evidence from a difference-in-differences analysis.
Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- High need, low use: separating multidimensional need from formal healthcare use among older adults in China using CHARLS 2020.BMC health services research · 2026Article
- Impact of the Family Doctor Contracting System on unmet healthcare needs in Shandong Province, China.Health policy and planning · 2026Article
- Why do they sign but not consult? A study on the effectiveness of China's family doctor contract services from the perspective of patient-doctor interaction.Frontiers in medicine · 2026Article
- From Legal Indeterminacy to Risk-Governed Continuity: Operationalizing Risk Governance for China's Family Doctor Contract Services.Risk management and healthcare policy · 2026Article
- Does Family Doctor Contracting Improve the Health of the Elderly: An Empirical Study from Beijing, China.Journal of multidisciplinary healthcare · 2026Article
- The association between china's primary health care reform and inequalities in primary care utilisation and maternal mortality: a quasi-experimental longitudinal study from 2010 to 2019.International journal for equity in health · 2025Article
- Article
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Authors and funding
5 authors.
Funding
Abstract
introductionIn 2016, the Chinese government officially scaled up family doctor contracted services (FDCS) scheme to guide patients' health seeking behavior from tertiary hospitals to primary health facilities.
methodsThis study evaluated the overall gate-keeping effects of this scheme on healthcare utilization of rural residents by using a difference-in-differences (DiD) design. The analysis was based on Shandong Rural Elderly Health Cohort 2019 and 2020. Participants who contracted FDCS in second round and were not contracted with a family doctor in the first round were regarded as treatment group. In total, 310 respondents who have used medical care were incorporated for final study.
resultsParticipants who contracted FDCS (treatment group) experienced a significant decline in the mean level of first-contact health-care facilities, decreasing from 2.204 to 1.981. In contrast, participants who did not contract FDCS (control group), showed an increasing trend in the mean level of first-contact health-care facilities, rising from 2.128 to 2.445. Our results showed that contracting FDCS is associated with approximately 0.54 extra lower mean level of first-contact health-care facilities (P = 0.03, 95% CI: -1.03 to 0.05), which suggests an approximately 24.5% reduction in the mean first-contact health-care facility level for participants compared with contracted FDCS than those who did not.
conclusionsThe study suggested primary healthcare quality should be strengthened and restrictive first point of contact policy should be enacted to establish ordered healthcare seeking behavior among rural residents.
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